Saint Louis University extends search for new medicines to treat childhood diarrhea

A $750,000 grant to the Center for World Health and Medicine at Saint Louis University will extend the search for new medicines to treat childhood diarrhea, which is the second leading cause of death of young children worldwide.

PATH's Drug Development program, established through an affiliation with OneWorld Health, is funding an extension of the project, which began in 2011 with a $645,000 grant that has yielded encouraging results.

"We received the additional funding because we have promising data and are trying to advance some potential drug candidates," says Pete Ruminski, executive director for SLU's Center for World Health and Medicine.

"There currently are drugs already studied in clinical trials for cardiovascular disease that use the same mechanism of action as the ones we're looking at right now. It's too early to say whether they could be effective, but we're excited to have the opportunity to continue studying this approach to treating a global health problem."

For children who live in the developing world, which is plagued by poor sanitation, malnutrition and a lack of knowledge about preventing the illness, diarrhea frequently is caused by drinking contaminated water. Also caused by a range of bacteria, parasites and viruses, it can be a symptom of a disease like cholera or rotavirus.

Diarrhea turns deadly because children who are sick become severely dehydrated and lose electrolytes and there is not an easy way to replenish fluids.

Pediatric diarrhea is not so lethal in the developed world, where children who become lethargic and dehydrated after a bout of illness can receive intravenous fluids at a hospital to recover.

"The issue is the lack of reliable access to rehydration therapy in the developing world," Ruminski says. "When you're in a developing country there may not be any facilities with IV fluids. We need an effective and inexpensive treatment option."

The Center for World Health and Medicine is studying the potential of anti-secretory drugs, which could prevent dehydration by slowing the production of fluids that rush through the intestines and out of the body. As part of the treatment, children would drink Gatorade-like liquids to rehydrate.

When a person has diarrhea, giving oral fluids can cause more diarrhea in the short-term, as waste flushes through the body. Believing their children actually are getting worse, some parents decide not to continue giving their children rehydrating liquids, with deadly consequences, Ruminski says.

If they are found to be effective, anti-secretory drugs could stop severe diarrhea so children could begin to drink and become rehydrated.

The Center also is studying different ways of giving the medicine - as a pill, a liquid suspension, or an intramuscular injection, mindful of what may be the most effective method of administration to an infant or child under real life field conditions.

Special treatments for children are necessary because the anti-diarrheal pill that generally is given to adults - Imodium (loperamide) - is not recommended for children. It works by a different mechanism, slowing down motility in the intestines so fluids and waste don't move through as quickly.

Each day, diarrhea kills more than 2,000 children under 5 worldwide.

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