Predicting the Unpredictable
Mark Kadrofske is an assistant professor in the Department of Pediatrics and Human Development at MSU and an attending neonatologist at Sparrow Hospital's Regional Neonatal Intensive Care Unit. His lab at MSU has been studying the role of the enteric nervous system on enterocyte migration and wound healing in the intestine.
Dec. 11, 2013
As a pediatric resident in Cleveland, I had a heartbreaking experience that changed my professional life. While working in the MetroHealth Medical Center Neonatal Intensive Care Unit, I saw twin infant girls suddenly become severely ill with bloody stools and black discoloration and distension of their abdomens. Their clinical status worsened and one infant had complete cardiovascular collapse and died. The other twin survived. The twins were born preterm but both were doing reasonably well clinically prior to the onset of these symptoms. This was my first encounter with an awful disease called necrotizing enterocolitis, or NEC.
NEC is an acute inflammatory disease of the intestine that almost exclusively affects preterm infants. Unfortunately, NEC can also be difficult to diagnose and its sudden onset and unpredictable clinical course makes it difficult to manage. Having a way to definitively recognize NEC at the earliest sign of trouble would be extremely helpful to the medical team and could possibly result in better outcomes for these infants.
For this reason, I have recently teamed up with Leanne Nantais-Smith from Wayne State University College of Nursing to identify "biomarkers" of NEC. These biomarkers might allow us to make an early and accurate diagnosis of NEC and may predict its severity. We are collecting urine and stool samples from preterm infants at both the Sparrow Hospital Regional Neonatal Intensive Care Unit and the Flint Hurley Children's Hospital, in collaboration with Ranjan Monga. The urine and stool samples are being analyzed in my lab for the presence of specific intestinal inflammatory molecules.
Performing a clinical study like this has been challenging and requires a lot of help, including key contributions from pediatric residents, dieticians and nurses. For their help and dedication, I am extremely grateful.
Little progress has been made in the prevention, diagnosis and treatment of NEC over the past 40 years, and the incidence of NEC has remained constant. This reality is a source of great frustration and motivates me on a daily basis. I am truly hopeful that our results from this biomarker study will change this reality.