2023 Fiscal Year Final Research Report
Establishment of a new cell therapy for short bowel syndrome that covers the prevention of IFALD
| Project/Area Number |
21K08639
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 55010:General surgery and pediatric surgery-related
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| Research Institution | Kyushu University (2023)
Niigata University (2021-2022) |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
木下 義晶 新潟大学, 医歯学系, 教授 (80345529)
小林 隆 新潟大学, 医歯学系, 准教授 (40464010)
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Keywords | 腸管不全 / IFALD / 腸内細菌叢 |
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| Outline of Final Research Achievements |
There were 9 patients with intestinal failure, 6 with short bowel syndrome and 3 with Allied Hirschsprung's disease. More than half of the patients found it difficult to wean the infusion. Six patients (66.7%) developed IFALD, but none progressed to liver failure and survived.
When we investigated the intestinal flora of children who developed IFALD, we found that more than half of them were gram-negative bacteria called Proteobacteria, which are considered pathogenic or bad bacteria. When intestinal lengthening surgery and GLP2 analog preparations were introduced, IFALD improved, and the intestinal flora decreased in the Proteobacteria phylum and became dominated by the Firmicutes phylum, suggesting that the intestinal flora influenced the development of IFALD.
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| Free Research Field |
肝移植、小腸移植、再生医療
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| Academic Significance and Societal Importance of the Research Achievements |
短腸症候群は、長期間中心静脈栄養を要することが多く、腸管不全関連肝障害(IFALD)を高率に発症し、致命的となる。そのため、中心静脈栄養からの離脱が重要だが、離脱は困難なことが多く、様々な因子が関係している。そこで、腸内細菌に着目し、調査したところ、IFALDを発症している患児の腸内細菌叢は乱れたdysbiosisの状況であった。腸管延長術や新規治療薬のGLP2アナログ製剤を導入するとIFALDは改善し、その状況の腸内細菌叢は改善を示していた。つまり、IFALD発症には腸内細菌叢の異常が影響している可能性が強く示唆され、腸内細菌叢を是正することがIFALD発症抑制の鍵になると考えられた。
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