Necrotising enterocolitis (NEC) is a disease of the premature gut and the most common cause of death due to gastrointestinal health issues in infants.
NEC triggers massive inflammation, causing parts of the small and/or large intestines to die. Widespread infection and multi-organ failure often ensue. It is a looming spectre that strikes unpredictably in preterm babies.
Diagnosis is difficult and there is no drug available to prevent or treat NEC. Around a third of babies with NEC require intestinal surgery, and up to two thirds of these don’t survive. For babies who make it, NEC can also have long-term impacts on development, including on the gut and the brain.
NEC research led by the Nolds offers fresh hope. Their discoveries have shed new light on how NEC develops and, as a result, identified new and existing drugs to treat the condition.
“Despite decades of research, NEC remains a major challenge in the neonatal intensive care unit because of its insidious onset, rapid progression, and the absence of an effective therapy,” Prof Nold says.
“By the time we know a baby has NEC, the infant is often already in a critical condition with sepsis (widespread bacterial infection) and sometimes life-threatening multi-organ failure. This renders neonatologists powerless to treat or prevent what still is for many babies a deadly disease, and for survivors a severely disabling condition,” he says.
The Nolds have discovered that an anti-inflammatory protein, IL-37, is lower in babies with NEC and when IL-37 is given as a supplement in preclinical models, it protects against NEC.
“Our data suggests that supplementing babies who have, or are at risk of developing NEC, with an IL-37 therapeutic or another drug that acts in a similar way, may prevent or treat the condition,” Prof Nold says.
“Absolutely, IL-37 could provide our tiniest patients with a much-needed therapy to shield them from NEC.”
The Nolds are collaborating with academic and industry partners to solve the complex challenges a new drug faces on its path to becoming available to patients.
- NEC affects between one and three in 1000 live births.
- Up to a third of babies with NEC die – a number that has changed little over the past 50 years.
- NEC is one of the most common causes of death in premature babies between days 15 and 60 of life.
- Of NEC-afflicted infants, 15–30 per cent need surgery – and up to two thirds of these babies don’t survive.