Crohn's Disease Research Round Up: Summer 2019
Crohn's disease is an Inflammatory Bowel Disease (IBD) that causes chronic inflammation in the digestive tract, leading to uncomfortable abdominal pain, severe diarrhea, cramping, and other symptoms.
The goal of Crohn's disease treatment is to reduce inflammation and reach and maintain remission. Existing treatments don't work for everyone living with Crohn's disease, and more research is needed into the causes behind the disease and how it can be better managed.
We gathered some of the latest research on diet's impact on Crohn's disease and what scientists are learning about the role of gut bacteria in the disease.
Connection between a skin fungus and Crohn's disease
A fungus commonly found in hair follicles is also found more frequently in the guts of people with Crohn's disease, compared with those without, a new study has found.
Levels of the bacteria were particularly high in Crohn's patients with a genetic variation known as the IBD CARD9 risk allele. This variant enhances the ability of cells to send out inflammatory substances in response to the bacteria.
Researchers found the bacteria in healthy people as well, suggesting that its role isn't completely negative, but for patients who already have inflammation, this bacteria seems to make it worse.
Next, researchers plan to explore whether removing the bacteria from the microbiome for Crohn's patients with this genetic variation would help alleviate symptoms.
Could a plant-based diet help Crohn's patients reach remission?
Most people with Crohn's disease find that certain foods trigger symptoms. These foods are different for each person living with Crohn's, but can include fatty foods, high-fiber foods, alcohol, and dairy products.
While developing a diet that works for Crohn's is an individual endeavor, interest in plant-based diets to improve symptoms have been increasing in popularity in recent years.
The latest research too add to the list is a new case study describing the experiences of a 25-year-old man who found remission for his Crohn's disease after following a plant-based diet. Another recent small study followed 70 Crohn's disease patients and found that a semi-vegetarian diet helped maintain remission in 50 out of 70 patients.
Other studies, however, have reported contradictory results. An abstract published in 2017 in the Journal of Gastroenterology, for example, suggested that neither vegetarian diets nor gluten-free diets improved Crohn's disease activity.
These mixed results suggest that the same diet may not work well for everyone living with Crohn's patients. If you're interested in trying a new diet for Crohn's, start slowly and consider working with a dietician to ensure you're meeting your nutritional needs.
Possible targets in the gut to help develop Crohn's treatments
Another recent Crohn's disease study, this one conducted at the University of Plymouth, also researched the role of gut bacteria in Crohn's disease.
The research focused on different types of cells called macrophages, which are part of our immune system. In Crohn's disease, macrophages drive the condition's signature gut inflammation. The way the tissue reacts depends on the type of macrophage cell present, and how it's stimulated. Researchers wanted to learn more about how these different types of macrophages work on the molecular to figure out whether they should also be targeted differently.
The research found that the molecular mechanisms of pro-inflammatory versus anti-inflammatory behaved differently in the presence of bacteria.
"This small step in understanding of differential off-signalling of macrophage type may go hand-in-hand with understanding the relapsing/remitting presentation of Crohn's Disease," study author Dr Andrew Foey told Science Daily. “It is suggestive of future research endeavours in targeting macrophage responses in the treatment of inflammatory diseases -- and it's a really positive step."
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