Research

The Hackam Lab - Pediatric Surgery

Overview

The laboratory of David J. Hackam, MD, PhD focuses on understanding the mechanisms that contribute to the development of necrotizing enterocolitis (NEC) which is the leading cause of death and disability from gastrointestinal disease in newborn infants. Dr. Hackam’s lab has identified a critical role for the innate immune receptor toll-like receptor 4 (TLR4) in the pathogenesis of NEC, and has shown that TLR4 regulates the development of NEC by tipping the balance between injury and repair in the stressed intestine of the premature infant.

Infant with NEC

What is NEC?

NEC is a devastating disease of premature infants. It strikes acutely and without warning. The typical infant with NEC is a relatively stable premature baby who suddenly develops feeding intolerance, abdominal pain and abdominal distention, and in severe cases, is either dying or dead from overwhelming sepsis within 24 hours. These stages are defined according to the Bell Staging System. If these tiny patients undergo surgery, extensive death of the small and large intestines is encountered. Current treatment is effective in only about half the patients, and involves resection of the dead intestine and use of broad spectrum antibiotics.

Our lack of understanding of the precise pathogenesis of NEC is highlighted by the fact that the overall survival has not improved significantly in the past 30 years, since the disease was first described.

Last Update
January 19, 2012