A Collection of Gastroparesis Medical Studies and Research

This article is from 2016, but I still think it's worth sharing. I also want to say that I will keep updating this article for any new studies, research, and new treatments for Gastroparesis. I want it to stay current and it might help someone.

Source: Unknown





According to EMORY:

"Minimally Invasive Procedure for Gastroparesis Shows Promising Results


A minimally invasive procedure at Emory University Hospital is showing promise in patients with gastroparesis, a digestive disorder in which the stomach does not empty food in a normal manner. The results of two small Emory studies were presented recently at the American College of Gastroenterology (ACG) in Las Vegas, where the researchers accepted the 2016 ACG Governor’s Award for Excellence in Clinical Research and the ACG Presidential Poster Award.

Gastroparesis occurs in diabetic patients and other patients with no underlying causes, where the muscles of the stomach and intestines do not properly function. Food then moves slowly or stops moving through the digestive tract.

In one study, Emory researchers performed a retrospective review of data in 10 patients who underwent gastric peroral endoscopic pyloromyotomy or G-POEM for gastroparesis. G-POEM involves guiding a small knife through an endoscope into the submucosal tunnel. Once there, an incision is made in the pyloric ring muscle to release the tightness of that muscle and normalize gastric emptying.

"In these 10 patients, clinical success was defined by improvement of symptoms measured with a decrease in the Gastroparesis Cardinal Score Index (GCSI) and no recurrent hospitalization," says Sunil Dacha, MD, assistant professor of medicine in the Division of Digestive Diseases, Emory University School of Medicine, and a former advanced endoscopic fellow with Qiang Cai, MD, professor of medicine in the Division of Digestive Diseases at Emory, who is an expert in the minimally invasive procedure. "We found G-POEM was clinically successful in eight of the 10 patients (80 percent) with a decrease in mean GCSI from 30.1 prior to the procedure to 12.8 at follow-up."

Gastric emptying studies were obtained on seven of the 10 patients following G-POEM. Results showed gastric emptying had normalized in five patients and improvements were noted in two other patients. Mean four-hour gastric retention decreased from 62.5 percent to 25.4 percent after G-POEM, indicating the stomach emptied much faster at four hours after a meal. A follow-up questionnaire also highlighted significant improvement in quality of life in several areas.

One patient in the study had no response and required hospitalization 15 days after G-POEM and another patient showed no improvement in symptoms.

A second study, presented at the ACG by Abhinav Koul, MD, a former Emory medical resident who worked with Cai, detailed three patients with gastroparesis who had failed gastric electrical stimulation, but showed improvement following G-POEM. Electrical stimulation of the gastric nerves by a small implantable device is one treatment option for patients with gastroparesis. In this retrospective study, Emory researchers determined G-POEM can be performed safely as a salvage therapy for patients with gastroparesis who failed treatment with a gastric stimulator.

The study also found G-POEM improved symptoms (mean GCSI decreased by an average of 64 percent from 27 to 10) as well as gastric emptying (60.6 percent to 18.3 percent mean average) in these patients. However, more data is needed to further define the role of G-POEM in this challenging patient population. Koul is now a clinical assistant professor at the Medical College of Georgia-UGA Medical Partnership at Athens Regional Medical Center.

"G-POEM is showing some positive results as an additional therapeutic modality for patients with gastroparesis who suffer with delayed gastric emptying," says Cai, who also serves as the director of the Advanced Endoscopy Fellowship at Emory. "We are only one of a few centers in the U.S. offering this specialized procedure."

In 2012, Cai started the POEM procedure at Emory University Hospital for patients with achalasia, a disorder of the esophagus that causes swallowing difficulties. He then developed the G-POEM program at the hospital, in hopes of finding alternative treatments for patients with gastroparesis."

Source: The above article



There is a new medication called, "Prucalopride," that is in trials right now for Gastroparesis. One of my friends brought this to my attention so I wanted to add it to this article. According to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263983/pdf/10.1177_1756283X11423706.pdf,

According to THE CLEVELAND CLINIC:

"New Program Offers Multidisciplinary Treatment and Hope to Patients with Gastroparesis


For patients with gastroparesis, long-term relief from nausea, vomiting and bloating may have seemed like an impossible dream. However, medical experts have discovered the secret to conquering this chronic condition. Effective patient care for gastroparesis requires innovative treatment combined with the expertise of physicians from multiple disciplines.


Challenges of traditional treatment

The most common treatments for gastroparesis include pain management, medication and surgery. However, using just one of these treatments is unlikely to relieve the patient’s symptoms. Physicians must consider the patient’s overall health, including diet, psychology and pain levels. When patients receive treatments from physicians in multiple disciplines, the overall treatment plan usually lacks cohesion and focus.

Because gastroparesis is such a rare disorder, few medical centers have had enough exposure to patients with this condition to develop effective treatment plans. Plus, the therapies are evolving so rapidly that many hospitals are struggling to keep up with the changes.

As a result, gastroparesis patients may spend a lot of time and money on various physicians and specialists who are not addressing their condition from a holistic viewpoint. A history of poor, ineffective treatments has left many gastroparesis patients very frustrated.


Convenient, multidisciplinary care

At the Digestive Disease & Surgical Institute, gastroparesis is the number one reason for patient referrals. This influx of patients gives physicians abundant opportunities to gain practical experience diagnosing and treating gastroparesis.

Currently led by Surgical Endoscopist John Rodriguez, MD, and Gastroenterologist Michael Cline, DO, the Gastroparesis Clinic offers a centralized place for patients to consult multiple specialists, including psychologists, gastroenterologists, pain specialists, nutritionists and surgical endoscopists. 'Because they have experience working together to support patients with gastroparesis, they know what works and what doesn’t,' explains Director of Surgical Endoscopy Matthew D. Kroh, MD. 'They also know whom to consult when they’ve hit a roadblock in the process.'

Following the patient’s initial appointments, the multidisciplinary team develops a treatment plan that’s tailored to every aspect of the patient’s condition. Throughout treatment, care team members stay in touch with each other and the patient, making adjustments as needed.The convenience of the Gastroparesis Clinic also contributes to patient ease. 'Our patients can schedule their appointments with multiple doctors over the course of one or two days, making scheduling one less thing that they have to worry about,' says Dr. Kroh. This is especially helpful for patients who must travel a considerable distance to seek treatment at Cleveland Clinic.



POP: Using surgical tools in endoscopic applications

The Digestive Disease & Surgical Institute’s Developmental Endoscopy Group recently used POP to treat several patients with gastroparesis. Led by Dr. Kroh and Medical Director Mansour Parsi, MD, MPH, these experts in gastroenterology, general surgery, colorectal surgery and interventional endoscopy work together to implement and refine POP procedures.

During POP, the physician cuts the pylorus, a muscular valve that empties the stomach, without surgery. Using advanced endoscopic tools, the entire procedure is performed through the mouth without the need for incisions. After the lining of the stomach is opened, only the pylorus is divided under high-definition vision, improving the emptying ability of the stomach.

By using an endoscopic method, the physician decreases the morbidity associated with laparoscopic surgery while delivering the same effectiveness for the patient. Traditional laparoscopic methods for dividing the pylorus muscle can result in pain from the incisions, herniation or leakage from the closure. POP eliminates the access trauma induced by open and laparoscopic surgery.

Many of the new endoscopic instruments and knives used in POP originated in Japan where physicians used them to remove early cancers. These pioneers in minimally invasive technology created a platform that allows Cleveland Clinic physicians to use surgical tools in innovative endoscopic applications.



Promising patient outcomes

The initial patient outcomes for POP procedures performed by the Digestive Disease & Surgical Institute look very promising. Immediately following treatment, physicians have noted symptomatic improvement as well as gastric emptying improvement.

'To finally be able to manage the full spectrum of care for patients who have suffered with gastroparesis for so many years is very rewarding,' says Dr. Kroh. 'Giving these patients the support and treatment they really need — and watching them steadily improve — makes it all worthwhile.'



Ongoing training and development

According to Dr. Kroh, the Developmental Endoscopy Group is busy training physicians in digestive disease fellowship programs at Cleveland Clinic to adopt the latest laparoscopic and endoscopic techniques. “When they graduate, these physicians will be fully prepared to help other hospitals implement innovative treatment programs for gastroparesis,” he reveals.

The Gastroparesis Clinic is a valuable resource for digestive disease physicians who lack experience in treating gastroparesis. 'We would love to have administrators or physicians from other hospitals work with us and do case observations through our clinic,' explains Dr. Kroh. 'This training would help them benefit from our expertise and put our technologies and treatments into practice.'

In support of the Gastroparesis Clinic, the Developmental Endoscopy Group will continue to develop laparoscopic and endoscopic procedures to treat patients with gastroparesis and other digestive disorders.

Source: Article above




According to HEALIO (from 2016):

"Latest Gastroparesis News, Research for Health Care Providers


An estimated 5 million Americans have gastroparesis, according to the International Foundation for Functional Gastrointestinal Disorders.

Michael Camilleri, MD, and colleagues detailed the management of gastroparesis in guidelines issued by the American College of Gastroenterology.

'Gastroparesis is identified in clinical practice through the recognition of the clinical symptoms and documentation of delayed gastric emptying,' they wrote. 'Symptoms from gastroparesis include nausea, vomiting, early satiety, postprandial fullness, bloating, and upper abdominal pain. Management of gastroparesis should include assessment and correction of nutritional state, relief of symptoms, improvement of gastric emptying and, in diabetics, glycemic control.'

In a statement for the record, Sen. Tammy Baldwin, D-Wis., brought attention to the condition, which can lead to issues in managing blood glucose levels, dehydration and malnutrition.

'While there is no cure for gastroparesis, some treatments, such as dietary measures, medications, procedures to maintain nutrition, and surgery, can help reduce symptoms,' she said. 'Unfortunately, gastroparesis is a poorly understood condition and so patients often suffer from delayed diagnosis, treatment and management of this disorder. As such, further research and education are needed to improve quality of life for this patient population.'

Relamorelin improves diabetic gastroparesis symptoms

Adults with diabetic gastroparesis experienced accelerated gastric emptying and reduced vomiting with 10 µg of subcutaneous relamorelin administered twice daily, according to phase 2 trial data. Read more.

G-POEM promising minimally invasive treatment for refractory gastroparesis

Mouen A. Khashab, MD, associate professor of medicine and director of therapeutic endoscopy at Johns Hopkins Hospital in Baltimore, discusses positive results from a study of gastric peroral endoscopic myotomy.

FDA issues draft guidance on clinical evaluation of gastroparesis drugs

'The purpose of this guidance is to assist sponsors in the clinical development of drugs for the treatment of diabetic and idiopathic gastroparesis,' the FDA wrote in the draft guidance. 'Specifically, this guidance addresses the [FDA’s] current thinking regarding clinical trial designs and clinical endpoint assessments to support development of gastroparesis drugs,' for which there is an “urgent medical need.'

Age, sex, obesity among factors that affect outcomes in gastroparesis

A recent study found that less than a third of patients with gastroparesis had significant symptom relief after treatment, and identified a number of independent predictors of symptom reduction. Read more.

FDA approves breath test for diagnosis of gastroparesis

The FDA today approved the Gastric Emptying Breath Test, or GEBT, a novel noninvasive diagnostic for gastroparesis.


References:

Camilleri M, et al. Am J Gastroenterol. 2013;doi: 10.1038/ajg.2012.373.

Statement in the Record Recognizing Gastroparesis Awareness Month. International Foundation for Functional Gastrointestinal Disorders website. Accessed August 18, 2016. (**Note, you can read more about topics and procedures in the article itself**)

Source: My friend Alley made this image.



Here are some additional blog articles that may help:

GASTROPARESIS PATIENTS VS DRUG SEEKERS.

GASTROPARESIS VS EATING DISORDERS.

INFORMATION ABOUT THE VAGUS NERVE.

New Neuro-Stim Device Lessened Abdominal Pain in Adolescents

I found this article and I thought it was really interesting. It might be a viable, possible treatment for people with gastroparesis. I am not familiar with it, so I apologize for the long article, but I wanted to share it and add it to my blog so that I can reference it later. It makes me happy that doctors are trying to find different treatments to help with gastroparesis and abdominal pain. It is a good step in the right direction. It will also help with pain from fibromyalgia and possibly for migraines as well. I know that it does not work for everyone.
However, I wanted to share the article anyway, to keep it in once place in my blog. Even though it may not work for everyone, I thought it was worth sharing and worth documenting in my blog for future research. The article is below.

"Electrical nerve stimulation introduces a potential non-pharmacologic treatment to address pain in adolescent patients who present with functional gastrointestinal pain disorders.
By Megan Garlapow, PhD With Adrian Miranda, MD, and Gary W. Jay, MD

Administering percutaneous electrical nerve field stimulation (PENFS) with Neuro-Stim, a FDA-cleared device manufactured by Innovative Health Solutions, in an adolescent population whose primary complaint was gastrointestinal pain, appeared to lessen subjective pain scores, according to findings published in The Lancet Gastroenterology and Hepatology.

The researchers were able to demonstrate that abdominal pain—the primary efficacy outcome of a difference from baseline to treatment—improved significantly in patients who underwent PENFS applied to the ear, as compared to those who had the sham treatment.1 The PENFS device must be applied by a licensed clinician.

Source:https://i.pinimg.com/736x/d7/3e/c6/d73ec617c2c77f196837e11f34305ff7--vagus-nerve-damage-electro-shock.jpg




Nerve stimulation device lessens gastrointestinal pain in teens; Efficacy Achieved Using Neuro-Stim for Gastrointestinal Pain


A randomized clinical trial in which 115 pediatric patients, ranging in age from 11-18 years old, who presented with abdominal pain related to a functional gastrointestinal (GI) disorder were treated at a single, out-patient clinic in the midwest.1

'We had heard about similar [favorable] results in other chronic pain conditions, but most results were from anecdotal reports,' said senior author Adrian Miranda, MD, a pediatric gastroenterologist and associate professor at the Medical College of Wisconsin in Milwaukee, 'We had to carry out a randomized controlled trial to properly assess the findings,' for GI pain.

More importantly, our preclinical studies demonstrated a reduction in the firing of neurons in the amygdala and spinal cord using the same technology,2 Dr. Miranda told Practical Pain Management, 'These central areas have been proposed by many to play a critical role in the development and maintenance of chronic pain.'

Functional abdominal pain disorders are a group of conditions, such as irritable bowel syndrome, abdominal migraine, and functional abdominal pain syndrome, in which pain is typically the most prominent complaint and symptoms are not caused by other conditions.




Study Design and Methodology

Patients were enrolled in the trial between June 2015 and November 2016. Researchers administered the non-invasive PENFS procedure via the external ear (n = 60) or a sham with no electrical stimulation (n = 55) for four weeks. The procedure was initiated with the intent to modulate central pain pathways. Patients were randomized equally to each arm with stratification based on sex, and presence or absence of nausea. Patients, caregivers, and researchers were blinded to allocation by group.

An outcomes analysis included 57 patients in the PENFS arm and 47 patients in the sham group after patients were excluded for discontinuation of treatment or for having organic disease.1

The primary efficacy endpoint—change in baseline reported abdominal pain—was assessed with the Pain Frequency Severity Duration Scale (PFSD), a subjective tool used to derive a quantifiable pain score in these young participants.1 The researchers used PFSD scores to assess improvements from the worst abdominal pain score as well as from a composite abdominal pain score.




Reduced GI Pain Was Sustained Following Neurostimulation

After three weeks of treatment, patients in the PENFS arm experienced a greater decrease in worst pain compared with patients in the sham arm (median score PENFS 5.0, IQR 4.0 - 7.0; sham 7.0, 5.0 - 9.0). The least-square means estimate of change in worst pain was 2.15 (95% CI: 1.37 - 2.93, P < .0001).1 Median composite scores of PFSD also decreased significantly in the PENFS arm, from 24.5 (IQR 16.8-33.3) to 8.4 (3.2-16.2), compared to the sham arm, which went from 22.8 (8.4-38.2) to 15.2 (4.4-36.8).1 Both worst pain and composite pain effects were reported for a median of 9.2 weeks during follow-up.1 The median worst pain was 2.0 points lower at follow-up in the PENFS arm but only 0.5 points lower in the sham arm (P < .0001). In addition, median composite pain at follow-up was 12.5 points lower in the PENFS arm compared to 6.0 points lower in the sham arm (P=.018). 'I know that ultra-high frequency can cause specific neurochemical changes that decrease pain,' said Dr. Gary W. Jay, MD, a clinical professor in the Headache Division in the Department of Neurology at the University of North Carolina, Chapel Hill. 'While I can at least get some idea as to why the reported pain decreased from this study, we don’t know what the parameters of electronic stimulation were, and they’ve done no testing other than filling out subjective forms, Dr. Jay told Practical Pain Management. Need for Further Understanding of Longterm Benefits

Dr. Miranda shared some additional information on how persistent this therapy might be at reducing abdominal pain.

'I have patients whose symptoms have resolved and are six months out of treatment while others have recurrence at five months,' he said, 'and it may be that a second treatment is needed for those who have recurrence, or perhaps a longer initial trial of six weeks would be required to prevent relapse.'

'It’s too early to tell, and certainly longitudinal studies need to be done,' Dr. Miranda said, 'Perhaps in the future, this therapy can be combined with imaging techniques to better predict the phenotype that will respond to treatment.'

Dr. Jay concurred with the need for imaging studies, particularly as PFSD is susceptible to issues surrounding subjective measurements. Objective, physiological measurements could yield meaningful insights into the biological basis of the results achieved in this study, according to Dr. Jay. He also noted that the study did not provide sufficient detail about the methodology used to employ electrical stimulation.

'The researchers are not giving us any parameters of what they are doing, and they are also not looking at whether there are any physiological changes occurring,' said Dr. Jay. 'You would want to do functional MRIs to see exactly what is this stimulation is doing.'




Conclusions and Future Directions

Dr. Miranda expects transcranial electrical stimulation to hold promise for additional pain disorders.

'I think we have just started to uncover the possibilities of neuromodulation, using peripheral electrical stimulation. The implications for this type of non-invasive neuromodulatory therapy holds promise beyond just functional pain disorders, in my opinion,' said Dr. Miranda, 'and if you think about the central mechanisms that are involved in chronic pain, there is really no reason why this technology couldn’t be applied to many pain disorders.'

Dr. Jay agreed that neuromodulatory electrical stimulation has the potential to improve other disorders characterized by pain.

'Given that some of the animal studies show amygdala or limbic system involvement secondary to the stimulation, which would make sense in certain disorders, I would want to see trials that at this aspect. The limbic system is very highly incorporated into another so-called functional pain syndrome, fibromyalgia,' he told Practical Pain Management.

Dr. Miranda explained the need for creating distinct therapeutic regimens for individual patients and emphasized the importance of understanding which components could form the foundation for such a regimen, including pharmacotherapy, physical reconditioning, and neuromodulation.

'We need to figure out who our responders are for each treatment and tailor our approach for each patient. There is not one treatment that will work for all patients,' said Dr. Miranda. 'Yet we don’t always discuss these components of treatment with our patients because of time constraints, lack of resources, or issues with insurance coverage,' Dr. Miranda said.

The American Neurogastroenterology and Motility Society funded this research. The authors have no other disclosures.



Sources
Kovacic K, Hainsworth K, Sood M, Chelimsky G, Unteutsch R, Nugent M, Simpson P, Miranda A. Neurostimulation for abdominal pain-related functional gastrointestinal disorders in adolescents: a randomised, double-blind, sham-controlled trial. Lancet Gastroenterol Hepatol. 2017;S2468-1253(17:)30253-30254.
Babygirija R, Sood M, Kannampalli P, Sengupta JN, Miranda A. Percutaneous electrical nerve field stimulation modulates central pain pathways and attenuates post-inflammatory visceral and somatic hyperalgesia in rats. Neuroscience. 2017;25;356:11-21."

I have another article that I have researched and written on the vagus nerve. You can find it here: http://www.emilysstomach.com/2016/07/information-about-vagus-nerve.html

There is another article I wrote about the vagus nerve stimulator, which can be found here: http://www.emilysstomach.com/2017/06/the-vagus-nerve-stimulator.html

Progressional Timeline of Gastroparesis/EDS/Dysautonomia Request for Research

Can you please send me a progression timeline of your Gastroparesis/EDS/Dysautonomia?


Please make a timeline and include years for - what happened right before you got sick, when you got sick, doctors visits and what they told you, any pain specialists, testings, test results, and your symptoms when you first got sick and symptoms before and now. Also, what do you think caused it? Include that in your timeline, too.

In addition to that, please write the dates for when you discovered other medical conditions before and after Gastroparesis. Please include whether you still have your gallbladder. If you no longer have your gallbladder, please put the date/year that you had it taken out. Were you diagnosed with Gastroparesis after your gallbladder was removed? When were you diagnosed with EDS or Dysautonomia or both? Do you have all three? Have you been diagnosed with more autoimmune illnesses once you were diagnosed with the first one? Do you have lupus or any other autoimmune illnesses? Please include those in your timeline, too.



I want to compare this to other people's progressive timelines. My goal is to find a common link between all of us and our GP.

Additionally, I can post results anonymously. If you wish to remain anonymous, just please let me know in the email that you send. I will ALWAYS respect your privacy.

PLEASE EMAIL YOUR TIMELINE TO EMILYSSTOMACH@GMAIL.COM AND INDICATE WHETHER YOU WANT TO BE ANONYMOUS OR NOT. ALSO, I NEED YOUR CONSENT STATED IN THE EMAIL THAT IT'S OK TO USE YOUR INFORMATION FOR RESEARCH AND PERMISSION TO HAND OVER ALL OF MY RESEARCH AFTER I WRITE MY PAPER TO A MEDICAL RESEARCHER WHO WOULD LIKE TO EXPAND ON MY RESEARCH. PLEASE INCLUDE YOUR CONTACT INFORMATION IF I NEED TO ASK YOU ADDITIONAL QUESTIONS.

Also, I wasn't trying to yell, but I wanted that to stand out since a medical researcher has gotten wind of the project. Keep in mind that when I hand over my research to her, names will be omitted but it could be a game changer for GP since this has never been done before.

I would like to receive a variety of samples - Idiopathic GPers, Diabetic GPers, Pediatric GPers, and Newly Diagnosed GPers. I want a variety of data to work with. So, if you think that you're not important because you're new to GP, you'd be wrong. I would also like to include the same with those with EDS and Dystonia.

Also, please include your AGE for data grouping. Please also include your name and contact information in case I need to follow up with you in depth with your timeline for any questions/concerns.

Also, if you can't remember dates, you can approximate or just write out your GP/DTP/Dysautonomia/EDS medical history. I can work with that, too. Excel might be the easiest way to put your information down.

Thanks again for participating in this research project.

Again, please email your GP Progression Timelines to emilysstomach@gmail.com.

If you can, please make your outline in an excel spreadsheet. It makes it easier for you to read and easier for me to sort. If you are a new GPer, just write about what happened before and after you were diagnosed. Include any complications.

Additionally, you can insert a chart in Microsoft Word or Open Office and add as many rows as you need. It helps to organize your information better if you want to go that route.

If you can't make it the way shown above, then you can do it straight down the Word document. You can write stories to go with each date and procedure you had done. The more information I have, the better our research will be.



This is an example of what mine would look like:

March 2012 - Diagnosed with GP

May 2012 - Went to Mayo Clinic.



I am compiling research so that it might inspire doctors to do a fully funded study to help us. The research could be a stepping stone for new ways of understanding GP to make new treatment and technologies! We can all be a part of something big - something life changing through research.

I have also asked Pediatric Gastroparesis to send us their children's GP Timelines. By having children thrown in the mix, maybe we could spot the common GP link between adults and children. They have graciously agreed to help me out with this project. Also, if you are an adult GP fighter with a child who is also a GP fighter, please send me both of your timelines. As always, I will be glad to keep in anonymous, just make sure you add that to the email. Please share this article around to others who have GP so that I can have a variety of samples, which will be really important.

I'm also curious as to what other medical conditions have resulted after you were diagnosed with Gastroparesis. I also want to know how many people have developed Gastroparesis after having their gallbladders out. So, please include that in your email: emilysstomach@gmail.com. If you think things are too trivial to put in your timeline, do it anyway. It might be really significant!

The ultimate goal I have is to put all of the common links and issues together and present my research (again, you can be anonymous) for doctors to pull medical records and expand on the research.

Basically, we are all being proactive because we want a cure! And, I don’t think this has ever been done before, so you could be a part of something truly amazing for GP history and its future!

For the First Time, Researchers Isolate Adult Stem Cells from Intestinal Tissue

For the first time, researchers isolate adult stem cells from human intestinal tissue

Filed under: CTSA, Research, Medicine, Cell Biology and Physiology, Biomedical Engineering
The accomplishment provides a much-needed resource for scientists eager to uncover the true mechanisms of human stem cell biology. It also enables them to explore new tactics to treat inflammatory bowel disease or to ameliorate the side effects of chemotherapy and radiation, which often damage the gut.
For the first time, researchers isolate adult stem cells from human intestinal tissue
click to enlarge.

The UNC study was published online in the journal Stem Cells.

Media contacts: Michelle Maclay, 919-843-5365; Les Lang, (919) 966-9366, llang@med.unc.edu

Thursday, April 4, 2013



CHAPEL HILL, N.C. – For the first time, researchers at the University of North Carolina at Chapel Hill have isolated adult stem cells from human intestinal tissue.

The accomplishment provides a much-needed resource for scientists eager to uncover the true mechanisms of human stem cell biology. It also enables them to explore new tactics to treat inflammatory bowel disease or to ameliorate the side effects of chemotherapy and radiation, which often damage the gut.

“Not having these cells to study has been a significant roadblock to research,” said senior study author Scott T. Magness, PhD, assistant professor in the departments of medicine, biomedical engineering, and cell biology and physiology at UNC. “Until now, we have not had the technology to isolate and study these stem cells – now we have to tools to start solving many of these problems”

The UNC study, published online April 4, 2013, in the journal Stem Cells, represents a leap forward for a field that for many years has had to resort to conducting experiments in cells from mice. While significant progress has been made using mouse models, differences in stem cell biology between mice and humans have kept researchers from investigating new therapeutics for human afflictions.

“While the information we get from mice is good foundational mechanistic data to explain how this tissue works, there are some opportunities that we might not be able to pursue until we do similar experiments with human tissue,” lead study co-author Adam D. Gracz, a graduate student in Magness’ lab. Megan K. Fuller, MD, was also co-lead author of the study.

The Magness lab was the first in the United States to isolate and grow single intestinal stem cells from mice, so they had a leg up when it came to pursuing similar techniques in human tissue. Plus the researchers were able to get sections of human small intestine for their experiments that otherwise would have been discarded after gastric bypass surgery at UNC.

To develop their technique, the researchers investigated whether the approach they had taken in mice would work in human tissue. They first looked to see if the same molecules they had found stuck on the surface of mouse stem cells were also present on human stem cells. The researchers established that these specific molecules – called CD24 and CD44 -- were indeed the same between the two species. They then attached fluorescent tags to these molecules and used a special machine called a fluorescence activated cell sorter to identify and isolate the stem cells from the small intestine samples.

They found that not only could they isolate the human stem cells from human intestinal tissue, but that they also could separate different types of intestinal stem cells from each other. These two types of stem cells – active and reserve – are a hot topic for stem cell researchers who are still trying to figure out how reserve stem cells cycle in to replenish active stem cells damaged by injury, chemotherapy or radiation.

“Now that we have been able to do this, the next step is to carefully characterize these populations to assess their potential,” said Magness. “Can we expand these cells outside of the body to potentially provide a cell source for therapy? Can we use these for tissue engineering? Or to take it to the extreme, can we genetically modify these cells to cure inborn genetic disorders or inflammatory bowel disease? Those are some questions that we are going to explore in the future.”

The research was funded by the North Carolina Translational and Clinical Sciences Institute (NC TraCS), home of the Clinical and Translational Science Awards (CTSA) at UNC.

Link to the Article is HERE.