Our Summary

This research paper is about a new method to study human intestines and the immune system. Scientists created a mini version of a human intestine, known as ‘human intestinal organoids’ (HIOs) from stem cells. Though these HIOs are useful to study how intestines develop and function, they don’t have immune cells, and thus cannot fully mimic real human intestines.

To overcome this, researchers transplanted these HIOs into mice that had been modified to have a human-like immune system. They found that human immune cells migrated into the HIOs and formed structures similar to the ones found in human intestines. When exposed to microbes, certain cells in the HIO increased and activated the immune cells, which then produced antibodies.

This new method provides a more accurate model for studying intestinal diseases caused by infections or allergens.

FAQs

  1. What are ‘human intestinal organoids’ (HIOs) and what are they used for?
  2. What was the limitation of HIOs and how did scientists overcome it?
  3. How does this new method improve the study of intestinal diseases caused by infections or allergens?

Doctor’s Tip

A doctor may advise a patient considering an intestinal transplant to discuss with their healthcare team the latest research on human intestinal organoids and how they are being used to improve understanding of the immune system in intestinal health. This knowledge could potentially lead to more personalized and effective treatment plans for patients undergoing intestinal transplants.

Suitable For

Patients who are typically recommended for intestinal transplant are those who have severe intestinal failure or dysfunction that cannot be treated with other medical or surgical interventions. Some common indications for intestinal transplant include:

  1. Short bowel syndrome: Patients with short bowel syndrome have a reduced ability to absorb nutrients due to a shortened or dysfunctional small intestine. This can result from conditions such as necrotizing enterocolitis, volvulus, or intestinal atresia.

  2. Chronic intestinal pseudo-obstruction: This condition is characterized by symptoms of intestinal obstruction without a physical blockage. It can be caused by abnormalities in the nerves or muscles of the intestines.

  3. Inflammatory bowel disease: Severe cases of inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, may require intestinal transplant if other treatments are ineffective.

  4. Motility disorders: Conditions that affect the movement of the intestines, such as gastroparesis or chronic intestinal dysmotility, may necessitate intestinal transplant to restore normal function.

  5. Intestinal tumors: Patients with benign or malignant tumors in the intestines may require intestinal transplant if surgical resection is not possible or if the tumor has spread.

Patients who are being considered for intestinal transplant undergo a comprehensive evaluation to assess their overall health and determine if they are good candidates for the procedure. The decision to undergo intestinal transplant is made on a case-by-case basis, taking into account the patient’s specific medical history and prognosis.

Timeline

Before intestinal transplant:

  1. Patient is diagnosed with a severe intestinal disease or dysfunction that cannot be treated with traditional methods.
  2. Patient undergoes extensive testing and evaluation to determine if they are a candidate for intestinal transplant.
  3. Patient is placed on the waiting list for a donor intestine, which can take months to years.
  4. Patient may experience worsening symptoms and decreased quality of life while waiting for a transplant.

After intestinal transplant:

  1. Patient undergoes a complex surgery to remove the diseased intestine and replace it with a donor intestine.
  2. Patient is closely monitored in the intensive care unit for complications and to ensure the new intestine is functioning properly.
  3. Patient is started on immunosuppressive medications to prevent rejection of the transplant.
  4. Patient undergoes extensive rehabilitation and physical therapy to regain strength and function.
  5. Patient is monitored closely for signs of rejection or infection for the rest of their life.
  6. Patient may experience complications such as infections, rejection episodes, or complications related to the immunosuppressive medications.
  7. Patient gradually improves and regains quality of life, with the goal of leading a normal and healthy life post-transplant.

What to Ask Your Doctor

  1. How does the process of intestinal transplant work?
  2. What are the potential risks and complications associated with intestinal transplant surgery?
  3. How long is the recovery process after an intestinal transplant?
  4. What medications will I need to take after the transplant and what are the potential side effects?
  5. Will I need to make any changes to my diet or lifestyle after the transplant?
  6. How often will I need to follow up with my doctor after the transplant?
  7. What are the success rates of intestinal transplants and what factors can affect the outcome?
  8. Are there any alternative treatment options to intestinal transplant that I should consider?
  9. How will the transplant affect my immune system and overall health in the long term?
  10. What are the potential long-term complications or risks associated with intestinal transplant surgery?

Reference

Authors: Bouffi C, Wikenheiser-Brokamp KA, Chaturvedi P, Sundaram N, Goddard GR, Wunderlich M, Brown NE, Staab JF, Latanich R, Zachos NC, Holloway EM, Mahe MM, Poling HM, Vales S, Fisher GW, Spence JR, Mulloy JC, Zorn AM, Wells JM, Helmrath MA. Journal: Nat Biotechnol. 2023 Jun;41(6):824-831. doi: 10.1038/s41587-022-01558-x. Epub 2023 Jan 26. PMID: 36702898