Integrating Novel Physiological Biomarkers of Feeding Intolerance in Preterm Infants

整合早产儿喂养不耐受的新型生理生物标志物

基本信息

批准号：
10739943
负责人：
Eric Brum Ortigoza
金额：
$ 16.74万
依托单位：
UT SOUTHWESTERN MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10739943
关键词：
16S ribosomal RNA sequencing Abdomen Address Age Area Bioinformatics Biological Markers Blinded Catheters Child Health Clinical Clinical Research Collection Complex Computer Models Cutaneous Data Dedications Development Development Plans Enteral Feeding Environment Feces Fostering Foundations Funding Gastrointestinal Motility Gastrointestinal Physiology Goals Growth Health Hospitals Ileus Infant Interruption Intestinal Obstruction Intestinal Perforation Intravenous K-Series Research Career Programs Knowledge Lead Leadership Learning Length of Stay Longitudinal cohort study Machine Learning Malnutrition Master of Science Measurement Measures Medical center Mentors Mesentery Methods Monitor Morbidity - disease rate Multicenter Studies Near-Infrared Spectroscopy Necrotizing Enterocolitis Neonatal Neonatal Intensive Care Neonatal Intensive Care Units Outcome Parenteral Nutrition Pathologic Pathology Physicians Physiological Pregnancy Premature Infant Principal Component Analysis Productivity Prospective, cohort study Proteobacteria Research Research Personnel Risk Sample Size Shotguns Signal Transduction Stomach System Taxonomy Testing Time Training Validation Very Low Birth Weight Infant Volatile Fatty Acids Work age related biomarker development biomarker validation career development cell motility commensal bacteria commensal microbes evidence base feeding gastrointestinal gut microbiome gut microbiota high throughput analysis improved outcome innovation metabolomics microbiome microbiota microbiota metabolites motility disorder multidisciplinary novel nutrition operation patient population perinatal medicine predictive modeling prevent programs prospective recruit segregation skills skills training stool sample tool translational medicine

项目摘要

1 Eric B. Ortigoza, MD, MSCR is a Neonatal-Perinatal Medicine physician with a Master of Science in Clinical 2 Research at UT Southwestern Medical Center (UTSW). His goal is to be an independently funded investigator 3 with expertise in neonatal gastrointestinal motility. He plans to investigate novel, comprehensive objective 4 methods to differentiate developmental feeding intolerance (DFI) from pathologic feeding intolerance (PFI) with 5 the goal of limiting unnecessary feeding delays, parenteral nutrition, and improving outcomes in preterm infants. 6 In a prospective, longitudinal cohort study, preterm infants who are born <32 weeks’ gestation will undergo 7 weekly non-invasive electrogastrography (EGG), abdominal near-infrared spectroscopy (aNIRS), and stool 8 collection. Dr. Ortigoza’s specific aims are to 1) quantify postmenstrual age-dependent differences in non- 9 invasive continuous gastrointestinal monitoring in preterm infants with DFI, PFI, and no feeding intolerance (NFI), 10 and 2) measure postmenstrual age-dependent differences in the gut microbiome and microbiota-derived 11 metabolites in preterm infants with DFI, PFI, and NFI. Dr. Ortigoza’s innovative approach integrates objective 12 gastrointestinal biomarkers of gastric motility, mesenteric oxygenation, bacterial colonization, and microbiota- 13 derived metabolites to differentiate DFI from PFI. The ability to differentiate between the two conditions will 14 encourage the development of predictive models for PFI in preterm infants using bioinformatics and machine 15 learning. The ability to predict PFI will help develop evidence-based strategies aimed at preventing and/or 16 treating episodes of PFI. Dr. Ortigoza has assembled a multidisciplinary team of mentors with expertise in the 17 key areas of computational modeling of complex physiological variables (Lina Chalak, MD, MSCS), advanced 18 gut microbiome profiling (Andrew Koh, MD and Julie Mirpuri, MD), and metabolite analysis (Andrew Koh, MD). 19 UTSW and its strong clinical research operation provide the ideal environment to conduct the proposed studies 20 with the large patient population at Parkland Health and Hospital System (PHHS) and Children’s Health, a 21 dedicated Center for Translational Medicine, and a strong record of clinical research participation. Dr. Ortigoza’s 22 Career Development Plan includes a comprehensive focused strategy to address the specific key training skills 23 that will allow him to transition to independence including: 1) developing expertise in complex signal analysis of 24 EGG and aNIRS data, 2) gaining expertise in interpretation of high throughput analysis of the gut microbiome 25 and its derived metabolites, and 3) developing expertise in biomarker development/validation. In addition, he will 26 receive training to develop leadership skills that are critical to fostering a productive research team and building 27 a successful research program. Together with his scientific aims, these goals will provide the skills necessary 28 for Dr. Ortigoza to build his independent research program in neonatal gastrointestinal motility.

1 Eric B. Ortigoza，医学博士，MSCR，是一位新生儿-围产期医学医师，拥有临床理学硕士学位 2 在 UT 西南医学中心 (UTSW) 进行研究他的目标是成为一名独立资助的研究者。 3 具有新生儿胃肠动力方面的专业知识他计划研究新颖、全面的目标。区分发育性喂养不耐受 (DFI) 和病理性喂养不耐受 (PFI) 的 4 种方法 5 限制不必要的喂养延迟、肠外营养和改善早产儿结局的目标。 6 在一项前瞻性纵向队列研究中，妊娠 <32 周出生的早产儿将接受 7 周无创胃电图 (EGG)、近腹部红外光谱 (aNIRS) 和粪便检查 8 Ortigoza 博士的具体目标是 1) 量化非月经后年龄依赖性差异。 9 对患有 DFI、PFI 和无喂养不耐受 (NFI) 的早产儿进行侵入性连续胃肠道监测， 10 和 2) 测量肠道微生物组和微生物群衍生的经后年龄依赖性差异 Ortigoza 博士的创新方法整合了 DFI、PFI 和 NFI 早产儿的 11 种代谢物。 12 种胃肠道生物标志物，包括胃动力、肠系膜氧合、细菌定植和微生物群 13 种衍生代谢物可区分 DFI 和 PFI 区分这两种情况的能力。 14 鼓励利用生物信息学和机器开发早产儿 PFI 预测模型 15 学习预测 PFI 的能力将有助于制定旨在预防和/或 Ortigoza 博士组建了一支具有专业知识的多学科导师团队，治疗 16 次 PFI。复杂生理变量计算建模的 17 个关键领域（Lina Chalak，医学博士，MSCS），高级 18 肠道微生物组分析（Andrew Koh，医学博士和 Julie Mirpuri，医学博士）和代谢物分析（Andrew Koh，医学博士）。 19 UTSW 及其强大的临床研究运作为开展拟议研究提供了理想的环境 20 由于 Parkland Health and Hospital System (PHHS) 和 Children’s Health 的患者人数众多， 21 个专门的转化医学中心，以及 Ortigoza 博士参与临床研究的良好记录。 22 职业发展计划包括全面的重点战略，以解决特定的关键培训技能 23 这将使他能够过渡到独立，包括：1) 发展复杂信号分析方面的专业知识 24 EGG 和 aNIRS 数据，2) 获得解释肠道微生物组高通量分析的专业知识 25 及其衍生代谢物，以及 3) 发展生物标志物开发/验证方面的专业知识。 26 人接受培训以培养领导技能，这对于培养富有成效的研究团队和建立 27 一个成功的研究计划与他的科学目标一起，将提供必要的技能。 28 日，Ortigoza 博士建立了新生儿胃肠运动的独立研究项目。