Vaccine: Possible Cure for Crohn's Disease

Hope has come for sufferers of a crippling bowel disease in the form of a new vaccine.

The news comes as fears are rising that Crohn’s disease is caused by a bug found in milk.

Human trials begin this summer on the innovative vaccine which researchers believe is a breakthrough in the battle to find a cure for the disease.

Scotland has one of the highest incidences of Crohn’s disease in the world with one in 200 people affected. The majority of these are young people and children.

Professor John Hermon-Taylor of King’s College, London is convinced a TB-like bacterium called MAP ((mycobacterium avian subspecies paratuberculosus) is the cause of the disease.

The bug causes a similar illness in cattle, sheep, pigs and primates, and he believes, once passed into the food chain, through milk or meat, causes most human cases of Crohn’s disease. The bacterium is now also being implicated in a similar inflammatory bowel disease, ulcerative colitis.

New research commissioned by the UK government has also revealed evidence that MAP may be the cause of Crohn’s.

In the report issued a few months ago by the Government’s Advisory Committee on Dangerous Pathogens, Dr Ingrid Olsen said: “Together with all the genetic susceptibility emerging over the last decade, it is very hard to reject the hypothesis of mycobacteria being involved in the development of CD.”

The report also reveals live MAP is much more prevalent in pasteurised milk supplies than previously thought.

According to Dr Irene Grant of the Institute for Global Food Security at Queen’s University in Belfast, 50 per cent of dairy herds in the UK are affected.

In the government report, she added: “Without effective control programmes, MAP infection has spread widely and unquestionably the potential for human exposure to MAP via milk, dairy products and potentially beef has risen too.

“There is evidence that the incidence of Crohn’s disease in various countries has been rising over recent years.”

The bug has also been found in high quantities in infant milk formula which the report says is of particular concern.

The latest evidence reveals the bacterium can survive pasteurisation at higher temperatures than previously thought.

Crohn’s disease and ulcerative colitis have rocketed in babies and children over the past few decades – rising by more than 80 per cent.

Gastroenterologists have described it as an “epidemic.”

The vaccine has already been successfully tested on animals and now human trials are due to take place in London in July.

A substantial number of cattle go on to develop an illness called Johne’s diseases, which, under a microscope, is almost identical to Crohn’s disease in humans.

Professor Taylor was the first doctor to make the link between Crohn’s and MAP.

Previously, the UK Government has said that transmission to humans of MAP from animals was not proven, despite evidence of it getting into the milk supply.

But a report in the World Journal of Gastroenterology in December 2015 disputes this after a study in India where MAP is endemic in livestock and the general environment.

More than 42,000 people were tested over a two-year period, including healthy individuals and MAP was detected in all categories of patients at different frequencies.

The report, “On deaf ears, Mycobacterium avium paratuberculosis in pathogenesis Crohn’s and other diseases” states: “The results clearly show, humans like other species, are equally susceptible to infection with MAP regardless of health status.

“This places whole populations at risk of infection, depending on the prevalence of MAP in the environment and food supply.”

The report indicates that MAP in humans works in a similar way as TB, where not all people who have the bug become ill. Those with MAP who do become ill, develop Crohn’s disease.

More info on the MAP vaccine which has been developed at the prestigious Jenner’s Institute at King’s College, London, can be found at crohnsmapvaccine.com

Professor Taylor said: “We believe there is compelling evidence pointing to MAP as the cause of Crohn’s disease. We are extremely confident that the vaccine will work.”

The professor says that MAP is highly resilient, and, milk apart, has also got into the water supply by being washed off fields where cattle graze.

Crohn’s disease leads to a chronic inflammation of the intestine, wrecking patients’ lives and sufferers are at high risk of bowel cancer.

At the moment, mainstream medication concentrates on treating the symptoms only and very often does not work. Three quarters of Crohn’s disease sufferers need major surgery.

The first phase of trials on healthy humans, costing £1.4million is being funded by HAV Vaccines Ltd. Funding is needed for the second phase.

Volunteers, mainly made up of Crohn’s patients and their families are also raising the £470,000 for a diagnostic blood test to run in conjunction with the vaccine trials. They have set up a fundraising Facebook page at www.justgiving.com/teams/crohnsmapvaccineheroes

Professor Hermon-Taylor says that the bacterium is resistant to standard anti-TB drugs and has learned to “hide” from the body’s immune defences by invading white blood cells. Its hidden presence unbalances the delicate physiology of the gut, making it leaky to other bacteria and food molecules, triggering inflammation.

In studies a majority of people with Crohn’s disease have tested positive for MAP and it has now also been isolated in some people with ulcerative colitis.

Source: .edinburghnews.scotsman

New Crohn's Research: Looking for a Cure

Closing in on a cure for Crohn's

By: Maureen McFadden - Email
Updated: Tue 6:52 PM, Jan 27, 2015
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More than 750,000 Americans suffer from Crohn's disease, a painful, chronic inflammation of the gastrointestinal tract that causes abdominal cramps and diarrhea.

Prescription medications may give some patients relief, but so far there is no cure.

Now, however, researchers say they have identified the bacteria that causes inflammation in some patients, helping them close in on a cure.

Eric Prado, 20, was a college freshman when he developed what he thought was a stomach bug.

"It feels like a stabbing pain, kind of all around," says Prado.

Doctors diagnosed Prado with Crohn's disease, a serious inflammation of the small bowel and colon.

Saleh Naser is a microbiologist from the University of Central Florida College of Medicine who specializes in Crohn's research. Naser says patients with severe cases can be virtually housebound.

"They have a chair next to the bathroom door where they have to go to the bathroom 15 to 20 times a day,” says Naser.

Naser has identified bacteria called MAP that could hold the key.

"This bacteria is known for a long time now to be responsible for the same symptoms we see in Crohn's disease, but in cows," says Naser.

As part of a clinical trial, Naser's lab is testing blood and tissue samples from Crohn's patients for the presence of MAP.

Patients are being given what Naser calls anti-MAP therapy; for one year, they take three antibiotics known to kill the MAP bacteria in the lab.

"If the bacteria is gone, then the symptoms should be gone," says Naser.

Prado is thankful his symptoms are mild and mostly controlled with medication.

“You don't know the future, sometimes you just have to be positive and keep doing what you do," says Prado.

65 clinical sites in three countries are participating in the MAP trial of the antibiotic therapy.

Naser says it's his goal to learn more about the bacteria and why some people are more at risk for Crohn's than others.

BACKGROUND: Crohn's disease is part of a group of conditions known as Inflammatory Bowel Disease (IBD). It can affect the entire thickness of the bowel wall and can "skip" areas, meaning there can be normal areas in-between patches of intestine. Since Crohn's is a chronic condition, the disease will have symptoms that flare up followed by periods of remission. Symptoms may include: fatigue, fever, diarrhea, abdominal pain/cramping, blood in stool, loss of appetite followed by weight loss, mouth sores and perianal disease (pain or drainage near the anus).
(Sources: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/, http://www.mayoclinic.org/diseases-conditions/crohns-disease/basics/symptoms/con-20032061)

DIAGNOSIS/TREATMENT: There is no singular test that can diagnose Crohn's; however it is a combination of information that doctors will use to determine the cause of symptoms. Physical examination, blood work, stool samples, and X-rays of G.I. tract are early tests and exams that can help determine diagnosis. An endoscopy can examine the colon and a biopsy can examine the tissue of the colon or affected area. The goal of treating Crohn's is to reduce the inflammation that causes symptoms. Anti-inflammatory drugs, immune system suppressors, and antibiotics are standards-of-care; as well as anti-diarrheals, pain relievers, iron and calcium supplements, and vitamin B-12 shots. Nutrition therapy, involving a low-fiber diet, may also be used to compliment medications; this will reduce the size and number of bowel movements. Surgery is also an option; however the effect is usually temporary because the disease can occur near the reconnected tissue.
(Sources: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/crohns-diagnosis-testing.html, http://www.mayoclinic.org/diseases-conditions/crohns-disease/basics/treatment/con-20032061)

NEW DISCOVERY: Mycobacterium avium subspecies paratuberculosis, or MAP, has been known for a long time to be responsible for the symptoms of Crohn's disease, but in cows, sheep and goats. Not all human cases of Crohn's are caused by MAP. Now, a simple blood test can identify the DNA of the MAP, allowing doctors to quickly diagnose or rule out Crohn's. A clinical trial is now underway, testing anti-MAP therapy which consists of three antibiotics known to kill the MAP bacteria. Saleh Naser, Ph.D., Microbiologist and Professor of Infectious Disease at University of Central Florida told Ivanhoe, "These antibiotics do kill the underlying cause of Crohn's which is MAP. If MAP is eradicated, the patient should be without any symptoms." Dr. Naser's team, as well as teams in several other countries, are conducting ongoing trials and hope to publish their findings within the next couple of years. For information on the clinical trial and recruitment locations, click here.
(Source: Interview with Dr. Naser)

Fecal Transplant Study As A Possible Cure

Inflammatory Bowel Disease 'Cured' With Fecal Transplant

January 22, 2015 5:06 PM
By Jessica Berman

Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, are extremely painful and can lead to colorectal cancer. Now, researchers have effectively cured the conditions in mice, offering hope for human sufferers of so-called IBDs.

Waste material from healthy people is rich in helpful bacteria. When transferred to the digestive tracts of sick individuals, in whom there is an overgrowth of bad bacteria, the fecal matter helps restore the balance of healthy flora.

Some cutting-edge doctors have used so-called fecal transplants to treat severe bacterial infections, including Clostridium difficile or C. diff, which releases toxins as it grows, attacking the lining of the intestines.

Scientists also have found the transplants appear to reverse autoimmune diseases of the bowel.

Crohn’s disease and ulcerative colitis, also known as inflammatory bowel disease or IBD, are life-long disorders that cause severe diarrhea, painful cramps and bleeding.

According to June Round, a professor of medicine at the University of Utah, such diseases are becoming increasingly common around the world, as more and more people eat a low-fiber, high-fat Western diet.

Round also blames the widespread use of antibiotics.

“So, I think a lot about the microbes that naturally reside in our bodies. And antibiotics can not distinguish between what is good and what is bad," she said. "They kind of wipe-out everything. So, there is a very clear-cut correlation between when Western civilization started using the antibiotics and the increased incidence of a lot of these autoimmune diseases.”

Currently, treatments for these conditions are supportive, designed only to ease the symptoms. So, the idea of a potential cure for IBD is very appealing.

In experiments with mice with inflammatory bowel disease, Round and her team found that fecal transplant restored the healthy balance of intestinal flora, returning the intestine to near normal.

But the notion of transferring fecal material from one person to another -- and in the case of mice, through a tube into the stomach -- makes many people say "yuck." So Round said researchers are now trying to identify the helpful bacteria in human waste so they can be put into pill form.

“You know, right now we have to do fecal transplantation because the [bacterial] communities are so complex, and we just do not know what organisms are doing the good thing," she said. "So, we just kind of put it all in there and hope for the best. So, there is no way of getting around it right now, but hopefully in the future there will be.”

The work is published in the journal Cell Host and Microbe.