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Newswise Columbus, OH. Premature babies face a host of medical challenges at birth, but none as deadly and mysterious as a disease called necrotizing enterocolitis (NEC). The condition creates an inexplicable combination of inflammation and infection that causes parts of the intestine to die. NEC progresses at a ruthless speed, leaving physicians with few options typically supportive care, emergency surgery or antibiotics. Only half of newborns who undergo surgery survive, and they often face serious life-long complications.

In the fifty years since necrotizing enterocolitis was first identified, weve accomplished relatively little to change its devastating course. Even worse, we dont know which babies will get it. One minute, a child can appear healthy, but then be dead from NEC hours later, said Gail Besner, MD, chief of pediatric surgery at Nationwide Childrens Hospital.

That may be about to change thanks to two major breakthroughs driven by Besner and Surgeon-in-Chief at Nationwide Childrens R. Lawrence Moss, MD.

After nearly two decades of work, their separate efforts have yielded both the discovery of a biomarker that can help predict which babies will get the disease, as well as treatments that can restore the intestines natural ability to protect itself against NEC.

These researchers advances offer innovative approaches to necrotizing enterocolitis that may someday make it a more predictable and better managed complication of prematurity, said John Barnard, MD, President of the Nationwide Childrens Research Institute and Pediatric Director of The Ohio State University Center for Clinical and Translational Science (CCTS).

Growth factors, stem cells offer gut protection For Besner, the key has always been to prevent NEC before it can start. In the 1990s, she began looking closely at what was happening at the molecular level to an immature bowel in the throes NEC. Besner made a major discovery, observing that a protein called heparin-binding EGF-like growth factor (HB-EGF) which she initially discovered played a life and death role in protecting premature infants from NEC.

In numerous studies, Besner showed that without HB-EGF, the structures within the intestines that maintain barrier function and integrity, including a massive network of nerves and blood vessels, became easily injured and beyond repair. The addition of HB-EGF had the opposite effect, helping protect intestines from injury in animal models of NEC.

From that molecular level understanding of NEC, Besner developed a bigger picture hypothesis about how the nerve damage within an immature gut impacted the diseases development and progression and where a solution might be found.

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Biomarkers, Stem Cells Offer New Ways to Treat Deadly Gut Disease in Premature Babies