Pakistani stem cell researchers to grow mini-intestines in a unique study into malnutrition


KARACHI: Karachi researchers at Aga Khan University are harnessing the power of stem cells to create mini-intestines that can provide new insights into how malnutrition occurs.

Malnutrition is a major public health problem in developing countries. According to the 2018 National Nutrition Survey, four in ten children under the age of five in Pakistan suffer from stunts while one in three children is underweight.

An unsanitary environment, contaminated water, inadequate nutrition, and poor maternal health during pregnancy are some of the main factors that lead to environmental enteropathy, or EE. EE is an important, but poorly understood, intermediate disease characterized by inflammation of the bowel that leads to chronic malnutrition.

Existing research on malnutrition has extensively documented its causes and highlighted the structural and genetic differences between a healthy and a malnourished bowel. To date, however, a number of ethical constraints and practical barriers, particularly in young children, have prevented researchers from studying how EE is created at the cellular level. Studies of the development of EE therefore require the development of models for healthy and malnourished viscera in order to study disease processes.

The Juma Research Laboratory at Aga Khan University is one of the few institutions in South Asia and one of the few selected institutions worldwide that has succeeded in growing entereroids or mini-intestines from intestinal biopsy tissue.

“Stem cell technology has enabled us to successfully grow intestinal organoids, or mini-intestines, from the tissues of malnourished children,” said Dr. Junaid Iqbal from AKU. “This provides us with an excellent model to safely conduct experiments to study disease processes, examine intestinal infections and vaccination failures in malnourished children, and identify various therapeutic strategies to reverse the effects of environmental enteropathy. This can increase our children’s chances of healthy growth. “

Dr. Iqbal and his team member, AKU assistant professor Dr. Zehra Jamil, received training on how to use these enteroids from one of the world’s leading laboratories at the University of Virginia.

In an extension of its work on malnutrition, the AKU faculty will work with researchers from the University of Virginia to investigate the effects of COVID-19 infection on malnourished intestines, one of the first such studies worldwide.

Recent studies on the coronavirus have found that the ACE-2 receptor, a protein that provides a route for the virus to enter the body’s cells, is present in both the airways and the intestines. This means the coronavirus is also infecting and growing in our intestines, which could explain COVID-19 symptoms like upset stomach and fatigue.

In the study, researchers will expose a range of gut entereroids to the virus to study how COVID-19 multiplies in the gut. You will also conduct studies to understand the dynamics of infection in young and old, and to assess how well malnourished viscera can defend themselves against the virus.

“Malnutrition is a major problem that affects children’s growth, cognitive potential and overall immune response,” said Dr. Iqbal. “Because it is so common in developing countries, it is possible that it may play a role in the pathogenesis and spread of COVID-19 in Pakistan and other countries in South Asia.

In the case of malnutrition, COVID-19 can worsen the development of children in our part of the world. That is why this study is so important. “

The study was funded by the Bill and Melinda Gates Foundation. Its goals are in line with the goals set out in Goal 2 of the Global Sustainable Development Goals: End hunger, achieve food security and improve nutrition, and promote sustainable agriculture, making special efforts to end all forms of malnutrition and stunts among children under 15 Years requires five to 2030.



Robert Dunfee