Despite a greater understanding of NEC physiopathology, modest progress has been done in terms of intervention and prevention of the disease over the past three decades, being the mortality rate unchanged. Investigators intend to leverage our knowledge and technical expertise developed with fetal enteroids to further investigate the processes leading to NEC by deriving and performing functional studies on human intestinal enteroids generated from intestinal resection for therapeutic reasons in NEC and non-NEC patients 1. Generate a tissue biorepository composed of: enteroids and other lamina propria cells 2. Comparative studies of the gene expression profile of tissue, epithelial enteroids and underlying lamina propria of NEC, non-NEC, hypoxic and non-hypoxic infants 3. In vitro functional studies for the evaluation of critical factors in NEC pathophysiology 4. In vitro functional studies to identify the activation of processes leading to intestinal epithelium necroptosis and/or apoptosis in bacteria challenged and hypoxic conditions 5. Correlative studies of the impact of perinatal variables on the intestinal barrier functionality at baseline and challenged with pathogens 6. In vitro comparison of the intestinal barrier functionality in infants complicated by condition of prenatal hypoxia versus non hypoxic infants 7. Validation the NEC enteroids as an in vitro model for the identification of treatments and prevention of NEC
Study Type
OBSERVATIONAL
Enrollment
18
Organoids are created from discarded tissue
Comparative studies of gene expression
assess the gene expression profile of tissue, epithelial enteroids and underlying lamina propria derived from NEC, non-NEC (further classified as hypoxic and non-hypoxic infants). NB: the unit of analysis will be the organoids derived from patients' tissues Investigators expect to be able to derive 1 cell line per patient, and the number of derived organoids will depend from the viability of individual cell lines.
Time frame: 2 years
functional studies barrier functionality
evaluation of barrier functionality at the baseline and in enteroids-derived monolayers challenged with pathogens, dead bacteria (as postbiotics), LPS, pharmacological agents, enteral nutrients and to evaluate innate immune response and barrier functionality as previously investigated in fetal enteroids and the contribution of myofibroblast, immune and ENS to the immune response
Time frame: 2 years
functional studies on cellular death
studies to identify the activation of processes leading to intestinal epithelium necroptosis and/or apoptosis in bacteria challenged and hypoxic conditions
Time frame: 2 years
Correlative studies of the impact of perinatal variables
Assess how the perinatal features (expression of the neonatal phenotype, as IUGR, chorionamnionitis, perinatal hypoxia) on the intestinal barrier functionality at baseline and challenged with pathogens
Time frame: 2 years
compare the intestinal barrier functionality in pathological conditions
comparison of the intestinal barrier functionality in infants complicated by condition of prenatal hypoxia versus non hypoxic infants
Time frame: 2 years
Validation of the enteroid NEC model
Validate the NEC enteroids as an in vitro model for the identification of treatments and prevention of NEC.
Time frame: 2 years
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