Children’s Hospital Los Angeles Investigator on Tissue Engineering: The Big Picture on Growing Small Intestines

CHLA Pediatric surgeon Tracy Grikscheit and colleagues describe the
progress and challenges of building new intestinal tissue for babies in
need

LOS ANGELES–(BUSINESS WIRE)–Babies born prematurely often face intense medical challenges, including
intestines that are underdeveloped or diseased. While an intestine
transplant can benefit some patients, many babies are simply too small
to endure this procedure. Children’s Hospital Los Angeles surgeon Tracy
Grikscheit, MD, is a leader in the field of tissue engineering –
growing intestines from stem cells. In an article published in the
journal Cell Stem Cell, Dr. Grikscheit and co-authors highlight how stem
cell 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 can
have dire consequences.

Most nutrient and water absorption occurs in the small intestine, so if
patients are not left with enough healthy tissue, they can suffer from
serious complications like malnutrition or dehydration – also known as short
bowel syndrome. In order to get the proper nutrients,
patients 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, small intestine transplant from donor tissue is the only
answer; but this, too, comes with its own list of problems. Babies must
be big enough for this procedure, which often means they need to wait
several months. Even then, the road is not an easy one. Patients must
take anti-rejection medications, which have their own side effects and
the success rate of transplantation is only about fifty percent.

With such challenges, the future seems bleak for these babies. To Dr.
Grikscheit, this is not acceptable. She wants more for her patients and
she envisions a world in which missing portions of intestines can be
grown.

Scientists like Dr. Grikscheit investigate growth of new tissue from
stem cells to treat babies with severe intestinal impairments. “Stem
cell therapies would really improve upon current options,” she says.
“Right now, these babies can either get a transplant, or live on IV
nutrition, which really impacts the way they can interact with the world
and develop. There has to be a better way.”

The
Cell Stem Cell article was written by Dr. Grikscheit and colleagues
as part of INTENS,
a European consortium that fosters research to treat children with
intestinal failure through tissue engineering. Tissue engineering is the
process of producing new tissue in the laboratory from stem cells. The
publication describes the progress researchers have made as well as the
challenges scientists face in bringing stem cell therapy to patients.

Stem cells have the capability of developing into any cell type, making
them ideal starting material for organ repair. The paper discusses 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 own
intestine or “off the shelf” – from a stock source of stem cells that
can be engineered into intestinal tissue. The two pathways each offer
distinct advantages to patients and the treatment type could depend on
the condition each child faces.

Research in this field is showing promise for future therapy. Recent
progress has allowed researchers to generate larger amounts of
intestinal tissue than ever before.

“We’re not yet at the stage of delivering this therapy to babies but
we’re developing the road map,” says Dr. Grikscheit. “We’re getting
closer.”

Co-senior authors of the article include Dr. Kim B. Jensen of the
University of Copenhagen and Dr. Paolo De Coppi of Great Ormond Street
Hospital and University College London. The
INTENS consortium is supported by the Horizon
2020 research and innovation programme (668294). Article DOI:
10.1016/j.stem.2019.04.018

About Children’s Hospital Los Angeles

Children’s Hospital Los Angeles has been ranked the top children’s
hospital in California and sixth in the nation for clinical excellence
by the prestigious U.S. News & World Report Honor Roll. The
Saban Research Institute at CHLA is one of the largest and most
productive pediatric research facilities in the United States. CHLA also
is one of America’s premier teaching hospitals through its affiliation
since 1932 with the Keck School of Medicine of the University of
Southern California. For more, visit CHLA.org, the child
health blog and the research
blog.

Contacts

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