SmartPill™ Administration to Assess Gastrointestinal Function after Spinal Cord Injury in a Porcine Model—A Preliminary Study

Abstract

Gastrointestinal (GI) complications, including motility disorders, metabolic deficiencies, and changes in gut microbiota following spinal cord injury (SCI), are associated with poor outcomes. After SCI, the autonomic nervous system becomes unbalanced below the level of injury and can lead to severe GI dysfunction. The SmartPill™ is a non-invasive capsule that, when ingested, transmits pH, temperature, and pressure readings that can be used to assess effects in GI function post-injury. Our minipig model allows us to assess these post-injury changes to optimize interventions and ultimately improve GI function. The aim of this study was to compare pre-injury to post-injury transit times, pH, and pressures in sections of GI tract by utilizing the SmartPill™ in three pigs after SCI at 2 and 6 weeks. Tributyrin was administered to two pigs to assess the influences on their gut microenvironment. We observed prolonged GET (Gastric Emptying Time) and CTT (Colon Transit Time), decreases in contraction frequencies (Con freq) in the antrum of the stomach, colon, and decreases in duodenal pressures post-injury. We noted increases in Sum amp generated at 2 weeks post-injury in the colon, with corresponding decreases in Con freq. We found transient changes in pH in the colon and small intestine at 2 weeks post-injury, with minimal effect on stomach pH post-injury. Prolonged GETs and CTTs can influence the absorptive profile in the gut and contribute to pathology development. This is the first pilot study to administer the SmartPill™ in minipigs in the context of SCI. Further investigations will elucidate these trends and characterize post-SCI GI function.

Conference Report: The FutuRE oF MinimalLy InvasivE GI and Capsule DiagnosTics (REFLECT) Nyborg, Denmark, October 2023

“…Among the non-white light capsule endoscopes (NWLCEs) already available for market or on trial for market approval is HemoPill (Ovesco Endoscopy AG), designed specifically for the detection of bleeding in the esophagus, stomach, and SB [ 11 ]. Others include Medtronic’s SmartPill [ 12 , 13 ], (now withdrawn from the market), and eCelsius (BodyCAP) for continuous core body temperature monitoring [ 14 ]. Capsule technologies on trial for market approval include sampling capsules such as the Recoverable Sampling System (RSS) [ 15 ], a tool in development as a supplement to OC, and the Atmo Gas Capsule (Atmo Biosciences), with continuous measurements of gases in the GI to provide insights into gut health and microbiome function [ 16 ].…”

Porcine Models of Neurotrauma and Neurological Disorders

“…We also received papers detailing new tools for use in pig neurotrauma studies. Knibbe and colleagues from the Boakye laboratory detailed the use of the SmartPill™ device for data collection from the gastrointestinal tract following spinal cord injury [8]. Ao and colleagues from the Vonder Haar laboratory also described a new reinforced touchscreen system for administering behavioral assessments in pigs [9].…”