Hirschsprung-associated enterocolitis (HAEC) is a life-threatening complication of Hirschsprung Disease, a common cause of intestinal obstruction in newborns. Hirschsprung Disease results from incomplete development of the enteric nervous system, or the “brain of the gut,” which is essential to life. HAEC affects 30 to 60 percent of infants with Hirshsprung Disease and is the leading cause of death in babies with the disease.
Ankush Gosain, MD, PhD, FACS, FAAP, associate professor of Surgery and Pediatrics in the Department of Surgery at the University of Tennessee Health Science Center, was recently awarded $2.1 million from the National Institutes of Health for his project titled “Dysbiosis in Hirschsprung Associated Enterocolitis Pathogenesis,” which will help determine how and why HAEC develops in order to discover prevention and treatment options and improve quality of life for Hirschsprung Disease patients.
“The biggest challenge we face in taking care of these babies and preventing or treating HAEC is that we do not know exactly how or why it happens,” Dr. Gosain said. “Our current treatments are limited to non-specific measures, including not letting babies eat or drink, invasive rectal washouts, and broad-spectrum antibiotics.” These treatments address the symptoms, rather than the cause.
Dr. Gosain also explained that dysbiosis, or a microbial imbalance, in HAEC patients results when something happens to upset the normal microbial balance that exists in our intestines and there is loss of beneficial bacteria, increased disease-causing organisms, and decreased overall diversity. “These are all found in HAEC, but we don’t know if these changes are a result of HAEC, or if they are the cause of HAEC,” he said. “Or, a little bit of both.”
Dr. Gosain’s lab is currently the only lab in the United States that is NIH-funded to study Hirschsprung-associated enterocolitis. This proposal builds on research he has performed for the last decade, which has been supported by the National Institutes of Health, multiple societies, and the Children’s Foundation Research Institute at Le Bonheur Children’s Hospital.