Study of Normal Intestinal Development and Disease in Premature and Term Neonates

Boston Children's Hospital100 enrolled

Overview

Current research on early intestinal development is primarily performed in mouse models. While useful in many other ways, mouse models are not ideal for studying human intestine development as the timing of this process differs between the two species. Further, prior research has demonstrated that some proteins and pathways that are critical in human development have no clear role in mice. This study aims to improve the overall understanding of critical aspects of intestinal development in humans. In addition, this study will investigate the impact of intestinal diseases that are found in the early stages of life such as necrotizing enterocolitis (NEC).

Study Type

OBSERVATIONAL

Enrollment

100

Conditions

NEC Necrotizing Enterocolitis Intestinal Disease Human Development

Eligibility

Sex: ALLMax age: 2 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Any neonate or infant through 2 years of age having intestinal surgery or intestinal biopsies from an esophogastroduodenoscopy (EGD) or colonoscopy. Exclusion Criteria: * Children \> 2 years of age. * Infants 0-2 years old not undergoing GI surgery or intestinal scope with biopsy procedure.

Outcomes

Primary Outcomes

Number of intestinal stem cells and mature epithelial cells

Small intestinal biopsy specimens will be collected either from discarded surgical biopsies collected for clinical reasons or from 1-2 additional small bunch biopsies (5mm) near the surgery site. The tissue will be used to 1.) generate organoids for longitudinal cell culture, 2.) analyze RNA or protein components by transcriptomic or cellular analyses or 3.) analyze histology. We do not have discrete planned outcomes because this is an investigational study and we are looking for new trends or differences.

Time frame: At the time of surgery for another clinical problem.

Degree of Immune System Changes

We will collect a small 1 tsp amount of blood (5mL) and use this to analyze immune cell types or cytokines in the blood. These will include monocytes, T cell, B cells, and neutrophils for the cell types. Cytokines will include IL-1, IL-2, IL-3, IL-4, Il-5, IL-6, Il-8, IL10, IL-13, IL-22, IL-33, TNFa, IFNg, IFNa, MCP1, MIP1a.

Time frame: Within 48 hours before or after the clinically-driven surgery.

Fraction of Stool Microbiome that has beneficial microbes

We will collect stool samples to analyze the microbiome using bulk microbial RNA sequencing.

Time frame: Within 48 hours before or after the surgery from which the biopsy is obtained.