This Week’s Inflammatory Bowel Disease Breakthrough

IBD, or Inflammatory Bowel Disease, is a medical term encompassing both Ulcerative colitis and Crohn’s disease. These conditions manifest when the immune system targets the bowels, triggering a multitude of severe symptoms such as abdominal discomfort, weight loss, diarrhoea, and bloody stools.

Amy Kelly, the Chief Executive of Crohn’s and Colitis Ireland, a charity that represents those afflicted with the disease, expressed that although both conditions exhibit almost identical symptoms, they impact individuals distinctively. They also influence disparate sections of the digestive tract.

“Crohn’s disease might affect any area of the digestive tract, stretching from the mouth to the anus, whereas colitis is typically confined to the colon”, Kelly elucidated. She highlighted that there currently is no cure for the disease, and sufferers alternate between flare-ups and periods of remission. Approximately 40,000 people in Ireland are diagnosed with IBD.

One common misapprehension conflates IBD and IBS or Irritable Bowel Syndrome. While both may produce alike symptoms, IBS is a condition where bowel contents move either too quickly or slowly, commonly accompanied with abdominal pain, as opposed to IBD which is a disease rooted in inflammation or ulcers.

In a significant breakthrough this week, researchers from the Francis Crick Institute, in collaboration with University College London and Imperial College London, provided new insights into what causes IBD, a disease that typically afflicts young people. The findings, published in the scientific journal Nature, pinpointed a segment of DNA only active in certain immune cells known to spur inflammation in the bowels. The discovery of the ETS2 gene as a critical element in the inflammatory reactions of ‘macrophages’, or immune cells, and their capacity to harm the bowel in IBD, indicates a wider range of potential treatment options.

The study authors underscored in their research that existing treatments have shown “limited effectiveness”, with a significant failure rate in drug development, thus emphasizing an “immediate necessity” to further comprehend the ailment and its functioning. Kelly suggests individuals with IBD may need to take medicine throughout their life and possibly need surgery to excise a section of their colon. Some may even necessitate a stoma bag.

Does this study pave the way for new treatments?

The study offers a beacon of hope for advancements in treatment choices. The team of scientists demonstrated that this biological mechanism could be targeted by drugs. While no specific medications block the ETS2 gene, the researchers found that cancer treatment drugs, known as MEK inhibitors, turned off the gene’s inflammatory effects.

Upon examination, the therapist noticed that the medication lessened inflammation in immune cells and in gut specimens from IBD patients. However, this medication may manifest side effects in other organs. Consequently, scientists are seeking methods to administer the drugs directly to immune cells. Clinical trials would be a prerequisite before this possible treatment strategy could be introduced to patients.

Christina Stankey, a PhD scholar at the Crick Institute and shared lead author of the study, noted that IBD along with other autoimmune conditions are “extremely intricate, with a mixture of genetic and environmental risk elements”. She added, “Uncovering one of the principal pathways that can be turned off with a pre-existing drug is a substantial leap ahead.”

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