Grant: Project Grant

Babies depend on the small bowel or gut to absorb nutrition. Some babies, especially those that are born preterm, can be born with a short gut, or have a surgical emergency after birth that causes the short bowel syndrome (SBS). These babies cannot stay healthy or grow without intravenous nutrition, called parenteral nutrition (PN) and PN at home or in hospital is very expensive. SBS is rare, but truly devastating. In the recent past, one third of babies with SBS died or needed an intestinal transplant. In Canada, two-thirds of intestinal transplants are due to neonatal SBS. To avoid death or transplant the babies must be able to stop PN. This is called adaptation, where the intestine grows and functions better. Babies can spend months or years failing to adapt and still die. The cost of medical care for the babies is more than 1.6 million US$ in the first 5 years of their life. From 2012-2016, we were funded by CIHR to develop a new baby model of SBS in piglets and to test a new therapy to help the gut adapt, using glucagon like peptide-2 (GLP-2). Our piglet model compared to all other models is the most like the severe SBS that babies develop. It has only been studied here, as our team includes a surgeon who also operates on the babies with SBS. We found GLP-2 did help the gut to adapt, but not to grow. When we added another treatment, epidermal growth factor, the gut finally grew. We want to now study insulin like growth factor-1, as we believe it will be even better than epidermal growth factor. We think that combining together these three treatments will be the very best way for the gut to grow, so that babies could stop the PN much more quickly. This will make a huge difference to the babies, to their families and will also reduce health care costs. It is exciting that GLP-2 is now being studied in children. This makes now the right time to do this study for babies with SBS in Canada.