Christchurch Hospital’s Department
of Paediatric Surgery has become the first in the world to create contracting
smooth muscle bowel cells, taking scientific medicine one step closer to being
able to create a functioning human small intestine.
The discovery follows extensive
research into a new technique that may eventually overcome the problem of short
bowel syndrome, without the need for prolonged total parenteral
feeding) or bowel transplantation – both of which have a high complication rate
and are very expensive.
Dr Atsushi Yoshida,
a paediatric surgeon from Japan
who has worked at Christchurch Hospital as a senior researcher for the last two
and a half years, has led the research under the supervision of Professor
Spencer Beasley, head of the paediatric surgical research unit.
Professor Beasley says this
technology will be particularly beneficial to children born with small
intestinal abnormalities as well as adults with Crohn’s disease who develop
One of the biggest challenges up
until now has been being able to grow muscle that contracts the same way bowel
muscle contracts, he says.
”Without this muscle the bowel
cannot push food through properly. It’s the first time such a discovery has been
made and could eventually provide an alternative to small bowel transplantation
and avoid all the issues of there being inadequate availability of donors, as
well as all the problems around rejection and immunosuppression,” Professor
“We have used induced pluripotent
stem cells reprogrammed from somatic cells and made them differentiate into
cells of the gut.”
stem cells are cells that have started as fibroblasts, but are made to change to
more primitive undifferentiated stem cells. These can then be manipulated to
change into a completely different type of cell such as a smooth muscle
Dr Yoshida says the technique
involves three highly technical steps.
“This is a significant breakthrough
because until now being able to achieve contracting sheets of smooth muscle
cells has proved very difficult,” Dr Yoshida says.
“We have found embryoid body
formation is influenced by cell number, culture methods, soluble factors used
and the culture periods. Already we have been able to develop bowel surface
cells (bowel epithelium) adjacent to the peristaltic smooth muscle.”
The next challenge is to refine the
technique so the sheets can be produced with greater efficiency and then employ
the tissue engineering techniques currently available, to replicate peristaltic
intestinal tubes with absorptive capacity. This means they will be able to both
absorb food and to contract to push the food onwards.
Dr Yoshida also hopes to generate
overseas interest and will be flying to Belfast, Northern Ireland, in a few days
to present his findings at the British Association of Paediatric Surgeons Annual
Scientific meeting next week.
Professor Beasley says the research
has been done through the Department of Paediatric Surgery, Christchurch
Hospital in conjunction with the Christchurch School of Medicine, University of
Otago. Other researchers involved are Kenny Chilcholtan and John Evans and it
has also been supported by the Christchurch Child Cancer Research
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