#337 - Targeting NEC at the Cellular Level, A New Frontier in Research

Hello friends 👋

In this episode, we sit down with Dr. Garabet Yeretssian, PhD, Senior Program Manager at the Chan Zuckerberg Initiative (CZI), to discuss how collaborative infrastructure and emerging technologies are reshaping research into necrotizing enterocolitis (NEC). Garabet shares how his background in GI inflammation and rare diseases led him to focus on cross-disciplinary research support, including CZI’s Rare As One Network and its emphasis on patient-led science.

We explore how tools like single-cell transcriptomics, organoid modeling, and AI-driven biomarker discovery are helping scientists better understand NEC pathophysiology — and potentially identify early risk markers. Garabet also talks about the growing effort to bridge the gap between adult GI research and neonatal care, and how aligning researchers, clinicians, and families can accelerate progress in diagnosis, prevention, and treatment.

The episode highlights CZI’s funding approach, which requires genuine collaboration with patient organizations, and outlines strategies for researchers and clinicians to engage with private funders. For those attending the NEXT Symposium, Garabet previews his role in sessions focused on inflammation, translational science, and scalable technologies.

Listeners can learn more and register for the 2025 NEXT Symposium at https://necsociety.org/nec-symposium/ using promo code incubator for 10% off.

Link to episode on youtube: https://youtu.be/jTbbYTlTF2Y

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Short Bio: Garabet is a Senior Program Manager on the Scientific Strategy and Partnership team at the Chan Zuckerberg Initiative, which he joined in 2022. Within the team, he oversees initiatives that support the development of scalable technologies to deepen insights into cellular behavior, with a focus on human metabolism, immune system, inflammation, and rare disease characterization. Trained as a cellular and molecular immunologist, he is passionate about applying patient-centered, disruptive thinking to advance biomedical innovations and bring solutions to improve patient care. Previously, he served as Director for the Helmsley Charitable Trust’s Crohn’s Disease Program, where he provided strategic leadership for a portfolio of diverse scientific and clinical grants. Before that, he was an assistant professor in the Immunology and Tisch Cancer Institutes at the Icahn School of Medicine at Mount Sinai, leading research on innate immune and cell death mechanisms in inflammatory bowel diseases, colorectal cancer, and other gastrointestinal disorders. Garabet holds a PhD in biotechnology, cell and molecular biology from the University of Nantes in France and has completed a postdoctoral fellowship at McGill University in Canada, studying host-microbe interactions at gut mucosal surfaces.

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The transcript of today's episode can be found below 👇

Daphna Yasova Barbeau: Hi everyone, today we are highlighting the upcoming NEC Symposium by the NEC Society. It’s September 7th through the 10th in Chicago, and it's not too late to register. Listeners of the Incubator can get 10% off registration using the promo code incubator, I-N-C-U-B-A-T-O-R. It’s a tremendous conference. We’ve had the good fortune to attend the last two, and I definitely recommend checking out the agenda at necsociety.org. We’re here to give people a sneak peek at some of the dynamic discussions happening at the symposium. I’m absolutely thrilled to introduce Dr. Garabet Yeretssian, who is part of the symposium faculty this year. Welcome, Dr. Yeretssian.

Garabet Yeretssian: Thank you. Thanks for having me.

Daphna Yasova Barbeau: It’s our pleasure. Let me tell people a little about you. You hold a PhD in biotechnology, cell and molecular biology, and completed a postdoctoral fellowship studying host-microbe interactions at gut mucosal surfaces. You’ve been a senior program manager on the scientific strategy and partnership team at the Chan Zuckerberg Initiative since 2022. Within the team, you oversee initiatives that support the development of scalable technologies to deepen insights into cellular behavior, with a focus on human metabolism, immune systems, inflammation, and rare disease. Previously, you directed the Helmsley Charitable Trust Crohn's Disease Program, and before that you were an assistant professor at Mount Sinai, leading research on innate immunity and cell death mechanisms in inflammatory bowel diseases, colorectal cancer, and other GI disorders.

So it’s no surprise that the NEC Society wanted you involved in this year’s symposium. Before we get into your role there, can you tell me a little about your work at the Chan Zuckerberg Initiative?

Garabet Yeretssian: At the Chan Zuckerberg Initiative, or CZI, I help lead efforts to leverage scalable technologies to better understand cells and their behaviors in health and disease. For a condition like necrotizing enterocolitis (NEC), having a deeper understanding of disease mechanisms is essential. The technologies we support at CZI can help us do that. I’ve worked at the interface of technology, science, and biology for many years—especially in the context of inflammatory and chronic diseases. Rare diseases have become a central focus, not only in terms of science, but also in building capacity for patient organizations and ensuring patients are at the table in research and decision-making.

Daphna Yasova Barbeau: I love that. Obviously, we’re here to talk about NEC, but can you share more about the breadth of diseases you’re looking at with this technology?

Garabet Yeretssian: Historically we’ve been disease-agnostic, because understanding health often helps us understand disease. More recently, though, our emphasis has been on rare conditions. NEC is one, but we’re really thinking about how to bring together patients, patient organizations, clinicians, and scientists to tackle complex conditions. That’s something CZI is known for—fostering collaboration by combining community engagement with technology development. It allows us to break down silos and prioritize patient needs from the bottom up, rather than a top-down approach.

Daphna Yasova Barbeau: I’ll come back to the “breaking down silos” concept, which we love on this podcast. But first, I want to highlight something I learned preparing for this conversation: the Rare As One network. It’s not just about funding research—it’s about a real commitment to patient-led organizations. I think it’s amazing that CZI doesn’t just provide funding but also supports infrastructure and scientific guidance. Can you talk about that?

Garabet Yeretssian: Of course. I’m one part of the puzzle, but many of my colleagues lead this work. The Rare As One network started from the belief that patient-led research is essential. Working with patients, not just for patients, is central to breaking down silos. The idea is to motivate clinicians and scientists to partner early with patients, to understand their needs and tackle them together. The Rare As One network now includes over 90 patient-led organizations across a wide spectrum of rare conditions. Our goal is to build their capacity so they can lead research in their fields and be true partners with scientists and clinicians.

Daphna Yasova Barbeau: That’s wonderful. And it aligns perfectly with what the NEC Society is trying to do—bring parents, patients, clinicians, and scientists together in a multidisciplinary way. We’ve seen surgeons, nutritionists, psychologists, and adult physicians all contributing, and it’s incredible to see adult GI research being translated to neonatal NEC. Why is that so exciting?

Garabet Yeretssian: This is close to my heart. I’ve worked in gut inflammation for many years. What’s exciting is how the NEC Society, through support like the Rare As One network, has built skills in research strategy, data sharing, governance, and community engagement. That’s allowed them to unite the NEC community and successfully apply for additional research funding, leveraging tools and technologies to better characterize NEC. It shows how much more we can accomplish by bringing the community together, compared to patients, researchers, or clinicians working alone.

Daphna Yasova Barbeau: Exactly. I’m in awe of researchers like you who not only do bench work but also recognize the need to collaborate with the community. We were talking earlier about how it can take more than a decade for research findings to reach the bedside. Using expertise like yours can help speed that process for patients.

Garabet Yeretssian: Yes, and there’s much we can learn from adult GI diseases that applies to NEC. That’s why CZI takes a disease-agnostic approach—we believe shared mechanisms exist across conditions. A treatment developed for Crohn’s disease, for example, might be repurposed for NEC in some patients.

There are parallels in mechanisms, biomarker discovery, and “-omics” tools—genomics, transcriptomics, proteomics—that have advanced rapidly. These tools let us better understand conditions like NEC, which affect infants at such a fragile stage of development, when the gut and microbiome are still maturing.

Daphna Yasova Barbeau: And it’s a two-way street. We hope to learn from adult diseases, but findings from NEC might circle back and inform those other communities as well. That’s really exciting. Can you tell us a little about what you’ll be speaking on at the symposium?

Garabet Yeretssian: We’ll finalize details at our faculty meeting soon, but I know I’ll be speaking about inflammation and new technologies—such as organoids and induced pluripotent stem cells—that allow us to study gene function, cell-microbe interactions, and immune responses in the gut. My focus is on early-stage and translational research—biomarker discovery, understanding mechanisms—rather than direct clinical therapies.

Daphna Yasova Barbeau: Could you highlight a few things for our listeners? Even as a clinician, I find it helpful to understand what’s happening at the bedside when we know what you all are studying in the lab. What are you learning about biomarkers or potential targets?

Garabet Yeretssian: Traditionally, biomarker discovery has focused on serum/blood samples. But in NEC, tissue-level profiling is more informative. By looking at what’s happening in the gut itself, we can learn so much more. One exciting area is single-cell transcriptomics, where we can see how individual cells regulate and express genes. This opens the door to identifying cellular biomarkers—understanding cell phenotypes in disease and targeting those directly, rather than treating downstream systemic markers.

Other omics approaches—proteomics, metabolomics, transcriptomics—generate massive datasets. These let us compare patients, identify commonalities and differences, and ultimately guide personalized treatment decisions.

Daphna Yasova Barbeau: I love that. If you could see into the future, do you suspect that this will help us with prevention, diagnosis, or—like you said—treatment? Or is this something that might help us with all three?

Garabet Yeretssian: Hopefully, I mean, if we want to be ambitious and have big hopes, hopefully all three. But at the initial stages, I see a big potential for prevention. If we could implement some of these marker identifications or biomarker identifications early on—just after birth, or even pre-birth—there may be ways for us to detect some markers early. Those could be extremely valuable for prevention.

When it comes to diagnosis and treatment, those are trickier scenarios because the timeframe for disease development and severity is quite fast. If we focus on prevention and getting interventions earlier, that could be much more impactful at the early stages.

In terms of diagnosing and treating patients, I’m sure that existing tissue biobanks and efforts spearheaded by the NEC Society in the past few years will be very useful resources for the community. They can help us start identifying real signatures of disease, understand the pathophysiology, and eventually leverage or repurpose existing drugs to accelerate therapy for these patients.

Daphna Yasova Barbeau: I love that. You mentioned these early markers, and especially with your expertise in other GI diseases, it sounds like there’s a push to evaluate whether some babies are at higher risk than others. For example, in the adult community, higher risk for colorectal cancer might be genetic, environmental, or related to in utero development.

As a clinician, we sometimes ask, why did this baby get NEC while another, higher-risk baby didn’t? It sounds like we’re trying to narrow down why some babies get it and others don’t.

Garabet Yeretssian: Yes. In adult GI, like Crohn’s and colitis, there’s a lot of work on identifying markers to classify or reclassify patients based on specific signatures in blood or gut cells, to predict who will respond to certain treatments. This approach is also common in rare diseases. NEC is heterogeneous. Patients respond differently, and disease onset and progression can vary. So we’re learning how to regroup or reclassify individuals to benefit from specific therapies, diets, or approaches. We can learn from other diseases, but NEC is unique—its short timeframe and rapid severity require us to consider these differences when designing prevention and treatment strategies.

Daphna Yasova Barbeau: We’re running short on time, so I want to move to another area of expertise: funding. NEC can be catastrophic, but it has relatively low incidence, which makes funding research challenging. Yet, its impact in terms of morbidity, mortality, and healthcare expenditure is significant. Funding this type of work requires collaboration between scientists, clinicians, and grant organizations, especially for rare diseases where there may not be a lot of government or industry support.

Garabet Yeretssian: Yes. This is one of the exciting parts of my work—translating complex science into something actionable. Patient organizations like the NEC Society help us partner with scientists, clinicians, and families to fund these efforts. The NEC Society has played a major role in the Patient-Partner Collaboration, which brings the patient perspective to the center of research. Funding is competitive and unfortunately scarce, but working with these teams allows us to accelerate biomarker discovery, diagnosis, and therapies for individuals with debilitating conditions. It’s very motivating.

Daphna Yasova Barbeau: Do you have recommendations for physicians or scientists hesitant about seeking private grant funding?

Garabet Yeretssian: Our funding is private but through open calls that anyone can apply for. One unique requirement is having a patient organization as part of the grantee group, with a lead PI from the patient organization. Without that, applications aren’t eligible.

My advice: share your research early and often, and communicate it with patients and families. Prioritize patient needs—they may differ from your lab priorities, but early collaboration is rewarding. Seek these opportunities and stay close to the communities you aim to serve.

Daphna Yasova Barbeau: I know we’ve been talking about rare diseases, but there are many grant resources on the CZI website. Can you explain how people can learn more about your work and other funding opportunities?

Garabet Yeretssian: There are multiple calls for CZI grants per year. The Rare As One network and Patient-Partner Collaboration are different initiatives, but we work closely with patient organizations like the NEC Society. We support basic research, technology development, rare disease characterization, and shared mechanisms across disease categories. We leverage AI for predictive modeling, aiming to anticipate patient responses and accelerate treatment rather than relying solely on biorepositories.

Daphna Yasova Barbeau: People can find these requests for applications on your website. There’s also a wide range of scientific meetings—some require grantee status, others don’t. We’re looking forward to your talks at the NEC Symposium. For those who want to learn more, visit necsociety.org. The NEC Symposium is September 7–10; use code INCUBATOR for 10% off. Dr. Yeretssian, thank you for sharing your insights and helping protect babies from NEC.

Garabet Yeretssian: Thank you, Daphna. This was a pleasure—thanks for having me.