Nearly 5 million people die every year from bacterial infections that resist antimicrobial therapies, with about 80% of these infections involving biofilms. These naturally formed communities of bacteria construct a web-like matrix inside the body, shielding the bacteria from immune cells and medications.
Gail Besner, MD, director of Pediatric Surgery at Nationwide Children’s Hospital and director of the Division of Pediatric Surgery with The Ohio State University College of Medicine’s Department of Surgery, has taken a new approach to biofilms. Her work focuses on protecting neonatal intestines from injury, particularly the devastating disease known as necrotizing enterocolitis (NEC), with a mortality rate approaching 50%. NEC occurs when the balance of beneficial and pathogenic bacteria in the intestines of premature babies is disrupted. Dr. Besner’s research has shown that when beneficial probiotic bacteria, such as Limosilactobacillus reuteri (L. reuteri), form biofilms, the beneficial effects of the probiotic are increased, leading to protection of the intestines from NEC.
“I think I speak for every pediatric surgeon when I say that we would love to never have to operate for NEC in these babies again,” Dr. Besner says. “When you talk to physicians and surgeons about biofilms, what immediately comes to mind is that biofilms are our enemy, because when produced by pathogenic bacteria, they prevent treatment of infection. However, when beneficial bacteria are induced to form a biofilm, the effect is spectacular.”
Dr. Besner’s team has developed a unique probiotic technology that induces L. reuteri to form a biofilm, making the bacteria more acid-resistant, better capable of binding to intestinal epithelial cells, more able to combat the immune system of the host and more capable of competing with the pathogenic bacteria around them.
“All of these effects make the probiotic in its biofilm state more capable of exerting its beneficial effects in protecting the intestines from NEC,” Dr. Besner says.
This approach has shown promise in reducing NEC. In addition to protecting the intestines from NEC, the therapy also protects the brain from the downstream harmful effects of NEC, improving neurodevelopment in animal models. The team has patented and licensed this technology to Scioto Biosciences, which is exploring its use in various gastrointestinal disorders and even autism spectrum disorder, another condition involving the gut-brain axis.
The contributions Dr. Besner and the team at Nationwide Children’s have made to biofilm research, and Dr. Besner’s innovative approaches to treating NEC, have the potential to transform clinical care for the most vulnerable patients cared for in neonatal intensive care units.