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This combination therapy, consisting of pancreatic enzymes (pancrelipase) and the bile acid ursodeoxycholic acid (UDCA), is being developed by the University of Oxford to reduce mortality in children with severe acute malnutrition (SAM). The treatment addresses the exocrine pancreatic insufficiency and impaired hepatobiliary function commonly observed in SAM, which contribute to intestinal dysbiosis, malabsorption, and systemic inflammation. By providing exogenous enzymes and bile acids, the therapy aims to suppress harmful bacterial overgrowth in the small intestine, improve the absorption of critical nutrients, and strengthen the gut barrier. This non-antibiotic approach is currently being evaluated in a Phase 2/3 clinical trial (the PEBA trial) funded by the Bill and Melinda Gates Foundation.
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