Discovering predictor for fatal infection in preterm babies

As a Neonatal Intensive Care Unit (NICU) nurse in the late 1990s, Katherine Gregory was both concerned and curious about necrotizing enterocolitis (NEC), a sometimes fatal infectious disease of the newborn gut affecting preterm infants.

The condition, one of the most serious complications of preterm birth, can cause severe infection, neurodevelopmental impairment, intestinal perforations, malnutrition, prolonged hospitalization, and even death.

The most challenging aspect of treating newborns with NEC was the vague and nonspecific signs and symptoms prior to its onset. Gregory and her NICU colleagues at Harvard-affiliated Brigham and Women’s Hospital (BWH) knew that once the symptoms manifested, the disease could be at an advanced stage and progress quickly.

“I would care for babies who survived the early stages of prematurity and seemed to be faring well, who would suddenly become catastrophically ill,” recalled Gregory.

Gregory’s work in the NICU prompted her to launch a research project that examined the physiology and pathological processes related to NEC, searching for a biomarker (a biological substance that indicates the presence of a disease or a pathogen). The predictor would enable clinicians to better anticipate, diagnose, and prevent the condition.

“The NICU team caring for preterm infants needed to be able to measure something that would give us a warning sign that the disease was imminent so we could be better prepared,” said Gregory, now a senior nurse scientist at BWH, who has devoted her career to researching gastrointestinal health and disease in newborns.

In collaboration with a multidisciplinary research team, Gregory successfully measured a biomarker for NEC called intestinal fatty acid binding protein (iFABP), a protein specific to intestinal inflammation and injury. She found that elevated levels of iFABP appeared in urine three and seven days before the onset of NEC symptoms. In 2014, her research was published in The Journal of Pediatrics.

“We have made some progress toward understanding NEC,” said Gregory. “However, this disease remains a major contributor to morbidity and mortality for preterm infants, so we have more work to do,” she added.

To read the full story and additional research being done by Gregory and her colleagues, visit BWH Clinical and Research News.