Aug 19, 2019 | Updated: 08:55 AM EDT

Progress and Challenges of Building New Intestinal Tissue for Babies in Need

Jun 08, 2019 09:49 AM EDT

Progress and Challenges of Building New Intestinal Tissue for Babies in Need
(Photo : Dr. Grikscheit, Children's Hospital Los Angeles)

Most times, babies born prematurely face intense medical challenges, including intestines that are underdeveloped or diseased. Though some patients can benefit from an intestine transplant, many babies are too small to endure this procedure. Tracy Grikscheit, MD, a surgeon at Children's Hospital Los Angeles, is a leader in the field of tissue engineering, growing intestines from stem cells. Dr. Grikscheit and co-authors highlight, in an article published in the journal Cell Stem Cell, how stem cells therapy is poised to become a game-changer for these babies.

Some premature babies are born with severely underdeveloped gastrointestinal tracts or can develop diseases like necrotizing enterocolitis, which attacks the intestines. In severe cases, surgical removal of the affected bowels (intestines) must be performed. This situation can have dire consequences.

Since it is inside the small intestine that most nutrient and water absorption happens, if patients are not left with adequate health tissue, they can suffer from serious complications such as malnutrition or dehydration, also known as short bowel syndrome. For patients to get the proper nutrients, they may have to be fed through a feeding tube or intravenously, through a needle into the bloodstream.

In the most severe cases of short bowel syndrome, a small intestine transplant from donor tissue is the only solution, but this, too, comes with its list of problems. Babies need to be big enough for this procedure, which most times means they must wait several months. Even then, the road is not an easy one. Patients must take anti-rejection medications which have their side effects, and the success rate of transplantation is only about fifty percent.

The future appears bleak for these babies with these challenges. And the situation is not acceptable for Dr. Grikscheit. She desires more for her patients, and she envisions a world in which missing portions of intestines can be grown.

Dr. Grikscheit, among other scientists, investigates the growth of new tissue from stem cells to treat babies with severe intestinal impairments. She noted that stem cell therapies would indeed improve upon current options. Right now, these babies can either get a transplant or live on IV nutrition, which impacts the way they can interact with the world and develop, and there has to be a better way.

Tissue engineering is the process of producing new tissue in the laboratory from stem cells. Also, stem cells can develop into any cell type, making them ideal starting material for organ repair. There are two main ways in which stem cells could potentially treat babies with these intestinal issues. Stem cells can either be taken from the patient's intestine or "off the shelf" from a stock source of stem cells that can be engineered into intestinal tissue. The two pathways each provide distinct advantages to patients, and the treatment type could depend on the condition each child faces. Dr. Grikscheit said that they are not yet at the stage of delivering this therapy to babies, but they are developing the road map and they are getting close.

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