The Intestinal Epithelium and Microbiome After Spinal Cord Injury: Gastrointestinal Dysfunction Mechanisms and Personalized Therapeutic Interventions
Abstract
Chronic spinal cord injury (SCI) causes damage to the spinal cord and additional complications that significantly affect health and quality of life after injury. These other complications include problems in the nervous system, immune system, and gastrointestinal (GI) tract. Current treatments are limited and have unwanted side effects. Because the causes of these secondary complications overlap, targeting the responsible factors may provide overlapping benefits. One promising treatment could be developed from recent work on the “microbiome.” Each of us has about as many bacterial cells in our body as our human cells, and they co-exist with us, helping us with many body functions such as nutrition, digestion, defense against viruses and other pathogens, immune regulation, etc. The bacteria that collect in different parts of our body (skin, mouth, gut) are referred to as the “microbiome,” each of which is unique to the area of the body and individuals. Researchers are interested in understanding which factors influence the specific bacteria that are present in these parts of the body, such as diet and exercise habits, and how those bacteria are related to health and disease. We are interested in studying the gut bacteria and intestinal tissue post-SCI to understand whether different types of bacteria are related to the gut transit time, constipation, and other GI complications. This information is important because GI problems are common after SCI and can severely impact quality of life. Additionally, some of the typical methods for dealing with GI problems, such as constipation, are not effective after SCI. Although persons with SCI could benefit from this research, only one clinical study has examined the gut microbiome after injury. In this study, changes were found in the gut microbiome after SCI that were related to bowel dysfunction. Our study will extend this important work by performing a comprehensive assessment of the gut microbiome and intestinal tissue function, which will allow us to develop treatments for people living with SCI. Our work will examine whether there are differences in the gut microbiome and in the function of intestinal tissue between people with SCI and those who are not disabled (control subjects). The main objective of this study is to examine the molecular function of intestinal tissue, the microbiome-associated factors that may be responsible for an altered gut microbiome after SCI, to assess the effects of these factors on intestinal tissue, and to collect and store clinical samples to use for treatment development. We expect that impaired tissue function and microbiome composition will be related to the delayed transit time observed after injury. We also expect to see a relationship between microbiome composition and the state of the nervous system, immune system, and metabolic system after injury. This is a two-part study of persons with SCI (n = 20; Tetraplegia/Paraplegia) and controls (n = 20; neurologically intact family members/caregivers). Visit 1: we will assess diet and exercise habits, prescribed medications and supplements (e.g., probiotics), frequency of bowel movements, and typical bowel routine components. Participants will complete a series of questionnaires for one month, after which they will collect a fecal sample. Visit 2: we will assess the state of the nervous system, immune system, and metabolic system by collecting blood and other laboratory measures. We will assess GI function with a diagnostic procedure called the “SmartPill” monitor. We expect that this study will take 3 years to complete. It is known that GI dysfunction greatly affects the quality of life after SCI and can worsen secondary complications after injury. These secondary complications are especially important to Veterans living with a SCI. The purpose of our study is to test our idea that changes in intestinal tissue function and the gut microbiome after injury is the common link t
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010697
Entities
People
- Sylvia Daunert
Organizations
- United States Army
- University of Miami