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Entering the intestines with a cart

Entering the intestines with a cart

Photographer:Fotograaf: Joey Roberts

Wishful thinking

Imagine you, a researcher, are given a bag of money, unlimited time and personnel. What research would you do? PhD candidate Johanna Kreutz (28) dreams of a Mars rover that, instead of filming and taking samples on the red planet, would do so in the intestines.

Whether she knows Martin Paul? She has known him her whole life. Her father and Paul have been friends for many years. They lived in the same street in Berlin. Kreutz was a babysitter for Paul's children for quite some time, when he and his wife went to the opera or a classical concert. It was also because of his recommendation - Paul was dean of FHML at the time - that she came to Maastricht to study Biomedical Sciences. In her first year, Kreutz lived with the Paul family. She refers to him as a kind of “second dad.”

Kreutz has lived in the Netherlands for ten years now, speaks fluent Dutch and married a Dutchman at the beginning of this month. She is a doctor and PhD candidate in paediatrics; she carries out research into coeliac disease, also known as gluten intolerance. This often develops in children between the ages of four and ten. The immune system regards gluten as being a threat, springs into action and in doing so damages the intestine. “I am researching the role of the intestinal wall in the development of coeliac disease. My theory is that these people, even before they become allergic, already have a damaged intestinal wall, exhibiting tiny cracks.”

The field is still very much in its infancy. “With adult test subjects, you can carry out an endoscopy for research purposes, in which you put a thin tube through the mouth down into the small intestine to take a biopsy. But you can't do that with children, the regulations are much stricter for them. In such instances, it is ‘No, unless’.”

Researchers are forced to work a lot with models, which they use to imitate the way the small intestine works, and use laboratory animals. “Irish setters are often used for this purpose, because they have a so-called gluten hypersensitivity. Mice and rats don't naturally have this, but after genetic modification they do. But no matter what, most animal research cannot be translated to humans.”

In short, Kreutz needs something new, something more advanced. And when she is with her husband - a researcher in the field of microbiology – relaxing with a glass of wine, the wildest of ideas sometimes emerge. “I would like to have a tiny Mars rover that would drive through the intestines, showing live and in real time everything that is happening inside. Something like a miniature nanotech cart that can film at a microscopic level and that can take samples using a gripper, just like on Mars.”

How would you get the cart inside the young patients? Simple, they would eat it, says Kreutz. “What we already do, is have patients swallow a tablet with a camera inside. Once it is in the intestine, it shoots a film. The advantage of the rover is that it can go anywhere, but it could also adhere itself to the intestine wall, so that it doesn't come back out after a couple of hours.”

The child would then go home and do everything he or she normally does. Meanwhile the nano cart would send live images to the doctor. “It would be helpful if the parents were to keep a diary of their child's activities, so that we could combine that information with the images.”

It is intriguing that a growing number of people is facing a gluten allergy. “Twenty years ago, it was 0.5 per cent of the population, now it is 1 per cent. In some countries, such as Finland, the counter is already at 2 per cent. It is still unclear why that is. The eating pattern is probably a factor, but most likely also the genes.”

This article is part of a special about Europe with Martin Paul, President of Maastricht University as guest editor-in-chief.

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