Crohn’s disease, which may affect as many as 780,000 Americans, is a type of inflammatory bowel disease (IBD). The condition is defined by chronic inflammation of the gastrointestinal (GI) tract, most commonly the end of the small bowel (the ileum) and the beginning of the colon, but it may affect any part of the GI tract. It differs from ulcerative colitis, another IBD, which is limited to the colon (or large intestine).
Crohn’s can affect the thickness of the bowel wall, and the inflammation can affect the bowel either in whole or in patches, leaving some normal area.
The cause of Crohn’s is not known, but research suggests that hereditary, genetic, and environmental factors may contribute to its development. What is known is that chronic inflammation is caused by an immune system attack on otherwise harmless bacteria in the intestines. These bacteria aid in digestion and attack and kill foreign invaders such as bacteria, viruses, and fungi. Scientists are making new discoveries that could aid in the treatment of Crohn’s and ulcerative colitis.
The RNF5 Gene—Scientists have recently discovered that a protein called RNF5 controls the activity level of another protein, S100A8, which is a promoter of inflammation. The researchers, at Sanford Burnham Prebys (SBP) Medical Discovery Institute in La Jolla, CA, and Technion-Israel Institute of Technology in Haifa, discovered that RNF5 “is the lock that keeps a key inflammatory protein under control,” according to senior investigator Ze-ev A. Ronai. “RNF5 also appears to be a potential predictor of disease severity, and could be used as a diagnostic marker,” he concludes. This discovery should lead to more consistent targeted treatments for those with Crohn’s and ulcerative colitis.
The microRNA-31 (miR031) Molecule—Researchers at Cornell and the University of North Carolina have reported that the levels of a single molecule can predict whether a Crohn’s patient has subtype 1 or subtype 2. Subtype 1 patients often do not respond well to medications and develop strictures—extreme narrowing of the gut tube, requiring surgery once it develops. Identifying as subtype 1 could help determine if a patient should pursue pre-emptive surgery. This identification can also assist future clinical trials in helping to determine if medications and treatments work better for one type or the other.
Olorinab for Abdominal Pain—Arena Pharmaceuticals has announced that a Phase 2a clinical trial of olorinab, an investigational drug, has demonstrated effectiveness in reducing abdominal pain in Crohn’s patients and appeared to be safe and well tolerated. They hope to continue development of the drug based on these results.
A Vaccine?—A trial is underway to test a vaccine that could treat Crohn’s. Dr. Jonathan Hermon-Taylor, a fellow of the Royal College of Surgeons, a professor of surgery at King’s College, London, and a retired physician and molecular scientist, has concluded that Crohn’s may be caused by a single bacterium— Mycobacterium avium subspecies paratuberculosos, or MAP, and is testing a vaccine could keep healthy people from developing Crohn’s and also give relief to Crohn’s patients. Outside experts are split on whether they believe a vaccine could actually work. The trial results will be announced in March of 2019.
While progress is being made in identifying possible targets for treatment, much more research is needed. A variety of medications are currently used to treat Crohn’s, such as anti-inflammatory drugs, antibiotics, and immune system suppressors, but no one treatment works for everyone, and some come with the risk of side effects, some severe.
“Chronic inflammatory conditions such as Crohn’s disease and multiple sclerosis have a very significant impact to people’s lives and new, targeted treatments are urgently needed…[N]ew discoveries provide us with vital information to develop new treatment strategies that could lead to a safe and effective way of switching off inflammation for treating disease,” said Dr. Ueli Nachbur, from the Walter and Eliza Hall Institute in Melbourne, Australia, who recently published research regarding critical immune pathways.
Increased research funding and participation in clinical studies is the best way to discover new and effective treatments for Crohn’s disease. Meridien Research has been conducting clinical research trials and studies since 2000 in central Florida. All studies are administered by board certified doctors and highly-trained medical personnel in St. Petersburg, Tampa, Lakeland and Maitland.