People with Crohn’s disease are typically treated with powerful anti-inflammatory medications that act throughout their body, not just in their digestive tract, creating the potential for unintended, and often serious, side effects.
In a new study from Scripps Research, researchers found a more targeted treatment approach is possible.
Crohn’s disease develops from chronic inflammation in the digestive tract, often the small intestine.
More than half a million people in the United States live with the disease, which can be debilitating and require repetitive surgeries to remove irreversibly damaged intestinal tissue.
In the study, the team found that certain immune cells in the small intestine have evolved a molecular sensing mechanism to protect themselves from the toxic effects of high bile acid concentrations there.
This sensory mechanism can be manipulated with small drug-like molecules and the treatment may help reduce small bowel inflammation.
Bile acids are made in the liver and released during a meal to help with digestion and absorption of fats and fat-soluble vitamins.
Because they are detergents, bile acids can cause toxicity and inflammation if the system becomes unbalanced. The whole process is kept humming along thanks to an intricate signaling system.
In the new study, the team used an advanced genetic screening approach to uncover how T cells sense and respond to bile acids in the small intestine.
The basic discovery that T cells dedicate so much of their time and energy to preventing bile acid-driven stress and inflammation highlights completely new concepts in how we think about and treat Crohn’s disease.
Also interesting, the team found that the bile acid-inflammation feedback system worked somewhat differently in the colon in concert with gut microbiome factors.
While gut flora had more influence on T cell development and function in the colon, it was a nuclear receptor called CAR that had more influence on inflammation in the small intestine.
Inflammation plays both positive and negative roles in the body. It can damage tissue, but it also suppresses cancer growth and fights infections. The current anti-inflammatory treatments shut it down systemically, throughout the entire body.
That can have potentially serious consequences, such as lowering resistance to infections or easing off the brake on cancer.
The team says directing treatment for inflammatory diseases only to the affected tissue would be preferable whenever feasible.
If you care about gut health, please read studies about too much sugar in meals may cause a leaky gut, fatty liver disease and findings of common gut disease linked to high risk of substance use disorder.
For more information about gut disease prevention and treatment, please see recent studies about these foods in common U.S. diets linked to inflammatory bowel disease and results showing that popular weight loss diet may influence your gut health.
The study is published in Nature. One author of the study is Mark Sundrud, Ph.D.
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