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)
