Grant: Project Grant

Preterm babies are at risk of short bowel syndrome (SBS) where the gut is too short to absorb the nutrition they need to live and grow. These babies must receive intravenous or parenteral nutrition (PN) to survive. Many of the babies require PN long term before their intestine can grow and change enough to absorb the nutrition they need and stop PN. Needing PN is a huge burden for the children and their families and can be complicated by severe infections and risk of death in early childhood. SBS that starts from birth is still the main cause of intestinal transplantation in Canada. This is a serious and costly problem. As babies with SBS are very sick we use piglets to test new treatments and to show they are safe before considering them for babies. In piglets we have been studying using gut hormones that can stimulate the intestine to grow in SBS. Unfortunately, these expensive treatments don't stop most children with SBS from needing PN. They may require less PN, but they may need the treatments forever and there is concern about side effects. In our laboratory, using neonatal piglets with SBS, we are trying to make the hormonal treatments work better to help babies stop PN faster. We know that babies with SBS have changes in the bacteria living in their intestine that impairs their gut health. Our piglets with SBS show the same changes. In both babies and piglets with SBS, abnormal gut bacteria contribute to increased infections and negatively impact the growth of the intestine necessary to stop PN. We believe the intestinal bacteria of babies and piglets with SBS can be modified by the hormone treatments and, in turn, the bacteria can change how the hormone treatments work. This idea has not been studied before and is important because we have ways to alter gut bacteria by giving probiotic bacteria or using antibiotics. Combining hormone treatments with probiotics could be a simple way to improve how the gut hormone treatments can help babies with SBS stop PN.