15 March 2019
Developing therapies to make my dream come true.
Gail E. Besner, M.D.
H. William Clatworthy Jr., Professor of Surgery
Chief, Department of Pediatric Surgery
Center for Perinatal Research
The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
Despite six decades of research, the morbidity and mortality of necrotizing enterocolitis remain relatively unchanged and this is completely unacceptable. It is critical to our goal of eradicating this devastating disease that a diverse array of stakeholders including parents, physicians, nurses, therapists, dieticians, scientists, and company CEOs get together to share experiences and to develop strategies to prevent and treat it. The SIGNEC annual meetings are tremendously inspiring, and in 2017 Professor Khashu asked everyone there to write a sentence about the disease. I wrote that my dream is to never have to operate on a baby with NEC again.
It is remarkable how quickly NEC can destroy parts of the bowel, and having to perform surgery on a baby with the knowledge that survival will be challenging is heartbreaking. So, the focus of the Besner Laboratory is to develop potential novel therapeutic strategies for preventing NEC and to make my dream come true. As I explained at SIGNEC in 2017, we have identified a novel delivery strategy that can improve the ability of probiotics to protect the intestines from NEC. The strategy involves the enteral delivery of the probiotic Lactobacullus reuteri in its biofilm state, which dramatically reduces the incidence of NEC after administration of just one single dose. All of the components of this delivery system are Generally Recognized as Safe (GRAS) by the US Food & Drug Administration, making this an exciting potential therapy for NEC that can be translated to the bedside in the near future.
Further studies from the Besner Laboratory have investigated the administration of stem cells in the prevention of NEC. Recent findings demonstrate that multiple different types of stem cells derived from either amniotic fluid, bone marrow, or the intestine itself, all protect the intestines from NEC with equivalent efficacy. In addition, exosomes (nano-sized particles) secreted from these stem cells are as effective as the stem cells themselves in protecting the intestines from NEC, thus representing a potential non-immunogenic, non-cell-based therapy for NEC in the future.
If you would like more information, please go to the Center for Perinatal Research at Nationwide Children’s; to follow us on Twitter, look up @NCHPedSurg and @nationwidekids. The buttons below will bring up my SIGNEC presentation (as it is a large file, it has been divided into two parts).
Stem Cell and Probiotic Therapy for NEC
Nigel J Hall MRCPCH FRCS PhD
Associate Professor of Paediatric Surgery
University of Southampton
Consultant Paediatric and Neonatal Surgeon
Southampton Children’s Hospital