Doody, of MassGeneral Hospital for Children, said he heard of Puder's results and tried the altered intravenous feeding on a sick patient of his own.
``There's no doubt it improved the immediate outcome for our child," who is now awaiting an intestinal transplant, Doody said.
Austin DuPonte's mother Joanne said she believes her son would have died without the altered IV feeding, known as Omegaven. Within two weeks of starting Omegaven, Austin -- who ``had every single preemie thing you could have go wrong" -- started to look better.
``I 100 percent attribute Austin's recovery and how well he's doing to Omegaven," she said. ``He is right on track for his adjusted age. He's excelling socially, far beyond where they think he should be."
The plant oil discovery came about through a combination of good luck, good timing, and good instincts. First, Dr. Jennifer Garza, then a surgical fellow at Children's Hospital, decided to tackle the problem of infants born with necrotizing enterocolitis -- a severe bowel disorder that mostly affects premature babies, many of whom then suffer liver failure. She asked Puder to supervise her work.
In discussing the subject in a meeting with Children's Hospital colleagues, Dr. Judah Folkman mentioned a study he and Dr. Robert Shamberger had done 15 years earlier on rats. In that study, rats that were given a diet of parenteral nutrition developed liver disorders, but if they got even a tiny amount of normal rat chow, the liver problems went away. ``So something in the chow was protecting the animals," said Puder, who repeated the experiment and found the same results.
Then, at the suggestion of clinical pharmacist Dr. Kathleen Gura, they decided to try the rats on Omegaven.
The results were an immediate surprise. The livers of the rats that got Omegaven looked perfect, while the rats that got the typical IV feed with plant oils looked terrible.
The next step should have been to test the idea in more animals -- but an emergency intervened.
Puder's partner, surgeon Russell Jennings, was treating a 5 1/2-month-old baby, Charles Rolfe, whose liver was failing. He ``urged me to `save this baby!' " Puder said.
``We asked permission from the Food and Drug Administration, from our institutional review board, and from the baby's parents," he continued. ``I hoped they'd say no," because the treatment was so untested. But everyone said yes.
Puder and his colleagues had to guess at the right dosage, but it worked. Charles, of Mashpee, began to get markedly better on the Omegaven feedings.
Now 2, Charles is ``the cutest little thing in the whole world," his mother, Alyson, said. ``He's got big huge blue eyes and reddish blond curly hair. He's a riot."
Although he still needs to be fed intravenously for 11 hours a day, Charles no longer needs a liver transplant.
Puder said his discovery has been the highlight of his professional life, and he plans to continue researching the possible benefits of Omegaven.
``If this is the only thing I do in my career, that's fine," he said. ``This isn't the end of the story, this is just the beginning." |
