May 2, 2024 – More than 1 million Americans and Crohn’s disease, A chronic and sometimes serious inflammatory bowel disease that affects the intestines and causes digestive problems. While some people may have mild or sometimes no symptoms, others develop severe abdominal pain, diarrhea, fatigue, weight loss, anemia and other life-threatening complications.
As yet, there is no cure for this condition, and treatments are often limited. Typical drugs to treat the disease, such as steroids and immunosuppressants, can provide relief and slow the progression of the disease, but many patients say they don’t respond well or at all over time. Although surgery may be an option in some cases, patients and doctors alike are eager to find new treatments that can help relieve symptoms and improve quality of life.
In recent years, gastrointestinal researchers have focused on overall solutions for inflammatory bowel disease (IBD), and Crohn’s disease in particular. As research funding pours in, gastrointestinal experts across the United States are testing new drugs that target inflammation and autoimmune responses, as well as fecal transplants that transfer “good” bacteria from the donor’s digestive system to help improve gut flora.
In 2024 alone, several developments were announced that could bring relief in different ways. In California, for example, researchers are developing a stem cell therapy that may help heal the intestinal lining and prompt a positive immune system response. The therapy has shown promising results in mouse models but still needs to be tested in human clinical trials. But it could provide a pathway for patients who don’t respond well to standard treatments or the latest drugs.
“Many new treatments and biologics for IBD have expanded over the past 10 years, but these drugs carry the risk of side effects, and at most, half of patients do not respond. If they do respond, the longer they take the drugs , the more likely they are to lose response,” said Maneesh Dave, MD, associate professor of medicine in gastroenterology and hepatology at the University of California, Davis.
Research stem cells
Dave, who heads stem cell therapy research at the University of California, Davis, points to other problems with current drugs. Serious side effects may include the formation of blood clots in the heart, lungs, and legs. These drugs often suppress the immune system, leading to an increased risk of infection and even cancer. That’s why Dave and others are working on solutions to improve remission rates, reduce side effects and get as close to remission as possible by treating inflammation and healing the gut.
in a Research published in January exist npj regenerative medicineDave and colleagues studied how a type of cells called human bone marrow-derived mesenchymal stem cells (hMSCs) healed inflammation in mice suffering from a form of chronic small intestinal inflammation similar to Crohn’s disease in humans. When hMSCs were given, the mice developed mucosal healing and immune responses even weeks after the hMSCs were no longer present.
“These cells can suppress the immune system and cause the intestinal lining to regenerate, which is very promising,” Dave said. “There is precedent in Europe where cells have been approved to treat specific conditions, but we don’t have evidence yet in the U.S. and clinical trials are ongoing.”
As research like this continues, Dave warns IBD patients against visiting unregulated stem cell clinics, which offer unproven treatments. The Food and Drug Administration has not approved any treatments in this area, so stem cell treatments are “still experimental” in the U.S. and could lead to infection or other serious complications, he said.
feel the explosion
When people with Crohn’s disease have an attack, they often experience abdominal pain, diarrhea, and sometimes blood or mucus in their stools. This change in symptoms means there is inflammation in the body and needs to be healed. At Northwestern University, a team of scientists has developed a wireless implantable temperature sensor to detect these inflammatory outbreaks in hopes of preventing or limiting the damage.
“Temperature changes are a hallmark sign of inflammation, and long-term inflammation can cause widespread damage to tissues or organs and may ultimately lead to the destruction of the entire system,” said Arun Sharma, Ph.D., associate professor of urology at Northwestern University’s Feinberg School of Medicine and McCormick School of Engineering. Research Associate Professor of Biomedical Engineering.
in a Research published in March exist Nature Biomedical EngineeringSharma and colleagues tested whether a temperature sensor, a tiny, flexible device that rests on the intestines, could provide immediate information about the progression and onset of the disease in mice with Crohn’s disease. Researchers used sensors to track temperature changes continuously for about four months and found that they could track the size of the outbreak based on the heat signatures. This means doctors can potentially take action sooner to help patients, rather than waiting weeks to test blood, tissue or stool samples.
Now that they have found successful results in mice, Sharma and the team plan to test the sensors in human tissue to recreate the inflammatory conditions found in Crohn’s disease. These types of sensors could also be used in patients with ulcerative colitis, another inflammatory bowel disease, or other conditions with a long-term inflammatory response, such as organ transplants.
“It would be important to have a platform that could instantly monitor outbreaks so treating physicians could take appropriate and timely action to help correct the situation,” he said. “With the advancements in technology we’ve described, there are One day this could become a reality and quality of life indicators for those affected could improve significantly.”
take care of children
Across the United States and Canada, IBD experts focused on pediatric patients are working together to find better solutions for children.called guest research (Clinical, Radiographic, and Endoscopic Findings in Children with Newly Diagnosed Crohn’s Disease), a study designed to understand why some children who receive standard therapy with anti-tumor necrosis factor (anti-TNF) drugs achieve mucosal healing while others do not .
“There are very few studies involving Crohn’s disease treatments in children, and all the drugs on the market are based on large studies in adults,” Neal LeLeiko, MD, professor of pediatrics at Columbia University and director of the Pediatric IBD Program at NewYork-Presbyterian Hospital, told Morgan Stanley Children’s Hospital. LeLeiko is the NewYork-Presbyterian/Columbia field investigator for the CAMEO study.
The researchers were particularly interested in finding the optimal anti-TNF dose in children, which may vary by body weight. For example, LeLeiko explained that when children receive intravenous medication and improve, they often gain weight, but the dose of the prescribed medication may not change, which could lead to a decrease in effectiveness. A key part of the study relied on a technique called “therapeutic drug monitoring,” in which researchers carefully measured routine blood tests and various aspects of treatment with anti-TNF drugs.
“I’ve seen too many patients experience failure with anti-TNF drugs because their previous doctors didn’t know how to use the drug properly,” he said. “As I always say, ‘What would I do if this were my child or grandchild?’ We need to know how to best use these drugs in children in the safest way.
