Researchers at the Stanley Manne Children’s Research Institute at Ann & Robert H. Lurie Children’s Hospital of Chicago released a study in early February that showed promising results in the treatment of inflammation caused by Crohn’s disease, as well as possibly preventing the need for future surgery for patients.
The study was conducted on a rodent model of mice that had been genetically manipulated to display “Crohn’s-like” chronic inflammation and ileitis. The need for a new treatment for Crohn’s disease was made clear in the early pages of the study, with researchers expressing the major impact their findings could have on those suffering from Crohn’s.
Currently, treatments for Crohn’s, while effective for some, present patients with possible severe side effects to prescribed medications. Another major challenge to overcome when finding alternative treatments for Crohn’s disease are patients who are, or who become, “refractory” during treatment. This means that a patient may already, or in the course of introducing antibodies, become resistant to treatment.
As a person’s condition worsens, and treatments begin to become less effective, surgeries such as a bowel resection become more and more likely. This is a major concern of nearly every patient diagnosed with Crohn’s, as nearly 75% of those diagnosed with Crohn’s disease will require surgery at some point in their life.
The breakthrough made by the study was found to be the direct injection of anti-inflammatory peptide amphiphiles into lesions in the small intestine of the mice that displayed Crohn’s-like inflammation. Anti-inflammatory peptide amphiphiles (AIFPA’s) are peptide-based molecules that can self-assemble into supramolecular structures. This, in short, means that AIFPA’s can alleviate inflammation caused by Crohn’s disease by transporting anti-inflammatory drugs across cell membranes without aid from antibody therapy or prescription drugs.
The results of the study showed the direct injection of AIFPA’s to greatly minimize the damage of tissue structure in the gastrointestinal tract caused by Crohn’s. It also showed to significantly reduce lesion size in tested subjects, most notably in the small intestine, where the majority of lesions are found in humans who suffer from Crohn’s. Lastly, the study showed increased intestinal transit or the amount of time it takes for food to travel through the small intestine. All of this points strongly towards AIF-PA’s use as a novel, stand-alone treatment for Crohn’s disease, and could prevent the need for surgery in patients.
Understanding Crohn’s Disease
Crohn’s disease is described by doctors as a type of inflammatory bowel disease, or IBD, that causes chronic inflammation of the digestive tract, which can lead to severe abdominal pain, diarrhea, intestinal obstruction, and perforation, and an increased risk of developing colon and small intestinal cancer. Patients with Crohn’s disease also suffer from a multitude of pervasive challenges including depression and negative body image.
The Crohn’s & Colitis Foundations of America reports that over 3 million Americans suffer from a type of inflammatory bowel disease, with nearly 750,000 of them diagnosed with Crohn’s disease specifically. While there is no known cause of Crohn’s disease, it is now believed that genetics, environmental triggers, weakened immune systems likely play a role in the onset of Crohn’s.
Current Treatments
Treatments for Crohn’s disease range concerning the severity of one’s symptoms, age, and by the recommendation of their primary physician. These include the implementation of antibiotic, and aminosalicylate treatment regimens for mild Crohn’s, while immunosuppressive agents such methotrexate, azathioprine, and mercaptopurine are used to treat more moderate cases.
Biologic and pharmacologic therapies are typically utilized to combat the most severe cases of Crohn’s and are composed of several classes of humanized antibodies. However, these antibodies come at the cost of severe side effects that can include bone marrow suppression, hepatitis/liver toxicity, and the increased risk of developing different types of leukemias, lymphomas, and skin cancers.
Finding an alternative to such tentative treatments for Crohn’s and other IBD’s would be a breakthrough in medicine, and could greatly improve the lives of millions of people.
“By modulating the cellular events that occur during chronic in-flammation, rates of morbidity can be dramatically mitigated along with its significant financial burden.”
What Does This Mean for Patients with Crohn’s Disease?
With current treatments for Crohn’s disease presenting major obstacles such as possible immunity to some therapies and severe side effects such as cancer or hepatitis, the promise of a safer, more effective treatment would bring hope to not only those with Crohn’s but the millions of people who suffer from IBD. In the closing remarks of the study, the promise of a new treatment was made clear:
“By modulating the cellular events that occur during chronic in-flammation, rates of morbidity can be dramatically mitigated along with its significant financial burden. We have demonstrated the early promise and feasibility of our in vivo anti-inflammatory PA platform for CD that could potentially be used as a solitary treatment regimen or used in combination with other known therapeutics. This will result in an improved understanding of the landscape involved with CD with far-reaching clinical implications toward other inflammatory diseases”
While the study has yet to make the transition to human subjects, the potential for a new treatment of Crohn’s disease may be on the horizon.
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