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Promising treatment for short bowel syndrome

Tissue-engineered donor-specific intestines could open the way to effective treatment of patients suffering from intestinal failure.

Health

Short bowel syndrome, or SBS, is a chronic and life-threatening condition that stops the body from absorbing the fluids and nutrients it needs to stay healthy. The result of about a 70 % shorter small intestine due to a birth defect or surgical removal, SBS leads to intestinal failure accompanied by symptoms of malnutrition, diarrhoea and dehydration. There is still no successful treatment for SBS. The only solution currently available is a small bowel transplant that has two serious drawbacks: donor organs are scarce, and patients need to undergo aggressive immunosuppression for the rest of their lives. However, recent scientific and technological advances have opened the way to new therapeutic options that could offer a ray of hope to young SBS sufferers. One such hope comes in the form of a strategy for donor-specific intestines developed with support from the EU-funded INTENS project. “Our aim is to deliver a functional small bowel that could be used to treat patients with SBS,” stated Prof. Paolo De Coppi of INTENS project coordinator University College London in a news item posted on the ‘News Medical Life Sciences’ website. The functional bowl reconstruction strategy involves autologous tissue engineering, an approach using cells or tissues obtained from the same individual. “This approach would allow us to overcome the shortage of organs and avoid the need for the risky practice of suppressing the patient’s immune response,” remarked Prof. De Coppi.

Engineering patient-specific jejunal grafts

The research team adopted this strategy in an INTENS-funded study focusing on the construction of autologous jejunal mucosal grafts. “We used biomaterials from SBS pediatric patients to engineer living tissue of the lining found in the small intestine that could, in theory, be surgically transplanted,” Prof. De Coppi explained in the news item. Analyses conducted during the study also brought to light similarities between the biochemical profiles of the small intestine and colon scaffolds, which are engineered materials used to form new tissues for medical purposes. These similarities suggest that scientists can use the small intestine and colon scaffolds interchangeably as platforms for intestinal engineering. “This opens the door to using the residual colon as scaffolding in children who have lost their entire small bowel,” observed Prof. De Coppi. As reported in the news item, the researchers subsequently transplanted the colon scaffolds in vivo to show that they’re capable of forming short-term functional structures. “These findings provide proof-of-concept data for engineering patient-specific jejunal grafts for children with intestinal failure, ultimately restoring their nutritional autonomy,” Prof. De Coppi noted. The results the INTENS (INtestinal Tissue ENgineering Solution) project has achieved so far have surpassed the team’s expectations. The innovative treatment can benefit infants with SBS, as well as children and adults. “Not only will this make treatment much more affordable and accessible for SBS patients, it also has the potential to substantially improve their prognosis and their standard of life,” concluded Prof. De Coppi. For more information, please see: INTENS project website

Keywords

INTENS, short bowel syndrome, SBS, small intestine, tissue engineering

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