Mark R. Frey, PhD

Mark R. Frey, PhD

Basic science advances continue across the breadth of gastroenterology research, but two areas in particular have seen significant recent advances. Studies of the microbiome and research into cell plasticity are moving from earlier descriptive work to more functional progress.

“The abstracts to be presented at DDW® this year show a lot of investigators starting to talk about actionable, nuts and bolts mechanistic findings in microbiome and stem cell work,” said Mark R. Frey, PhD, co-chair of the AGA Basic Science Program Committee. “These two areas are starting to mature to the point where we can begin to talk about translation without being whimsical.”

Neither the microbiome nor cell plasticity is a new topic at DDW. What has changed this year is the number of abstracts accepted in these two areas and the functional findings being presented.

“In the past, we saw a lot of abstracts about disturbances in the microbiome,” noted Dr. Frey, associate professor of pediatrics at the Keck School of Medicine at the University of Southern California, Los Angeles. “Until very recently, we have known little about the functional implications of those disturbances and how you might try to manipulate the microbiome except in very specific use cases. This year we will be hearing about ways the microbiome affects the GI tract and other organs in the body, and how you might start making cause and effect links and pulling the right strings to improve health.”

Some microbiome work has already turned clinical. Fecal microbiome transplantation (FMT) is currently used to treat recurrent C. difficile infection. This year, look for abstracts advancing FMT into inflammatory bowel disease and other areas.

Basic discoveries in stem cells and cell plasticity are showing a similar transition toward findings with clear clinical implications. A series of surprising discoveries has kicked started the discovery process.

“A number of labs recently described stem cell-like behavior in regions where there weren’t supposed to be any stem cells. This made us realize we don’t know enough about how cell plasticity is regulated,” Dr. Frey said. “Abstracts this year show a lot of progress in understanding cell plasticity, how the stem cell state is maintained, and how mature cells decide to change their fate to heal wounds and repair tissues. We are starting to think about ways to stimulate cell differentiation in clinically useful directions or leverage the activity of stem cells to make tissue-engineered organs or drive repair and regeneration.”

Meanwhile, a growing number of researchers are focusing on rare intestinal secretory cells, the enteric nervous system and other cell types that have long been understudied because they are difficult to work with. Basic descriptive findings are moving toward work on functional links between different cell types in the GI tract.

“For example, if you want to build a tissue-engineered colon for a child that had to have a colectomy, you want it to be innervated so that it functions properly,” Dr. Frey explained. “We know a lot more about the enteric nervous system today and can begin to explore and manipulate connections between different cell types to achieve that kind of functionality.”