Media release from Canterbury DHB

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 nutrition (intravenous 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 serious complications.

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 Beasley says.

"We have used induced pluripotent stem cells reprogrammed from somatic cells and made them differentiate into cells of the gut."

Induced pluripotent 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 cell.

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 Trust.