Crohn’s disease is a chronic disease which causes inflammation of the lining of the digestive system, and it affects around 115,000 people in the UK (1). While there is currently no cure for Crohn’s disease, treatment with anti-inflammatory drugs can help alleviate symptoms.
Approximately 70 % of patients with Crohn’s will eventually require surgery to remove damaged parts of the digestive tract, for instance gastric bypass surgery. Around 39 % will need a second operation as well.
The new findings regarding Crohn’s disease are based upon existing knowledge, and they could potentially lead to more efficient strategies and more personalised treatments targeting the gastrointestinal condition. Not all patients benefit from the current treatment solutions, and according to researchers, the reason for this could be that some patients suffer from one subtype, which is treatable using current medication, whereas others suffer from a different subtype which is not treatable using current treatments.
The study
Researchers studied 21 Crohn’s patients by analysing colon tissue samples that looked healthy and non-inflamed. They then mapped the gene expression patterns and found that there were two distinct groups.
The cells in one group had a gene expression similar to that of healthy colon tissue. However, the gene expression in the second subtype resembled patterns seen in the ileum, which is the portion of the small intestine that empties into the colon. Many of the genes that were varied between the two Crohn's subtypes were markers that distinguish the colon from the ileum.
Secondly, the researchers analysed tissue from the ileum of 201 children who had recently been diagnosed with Crohn’s disease and who had not yet been treated. Here, the researchers observed that despite the fact that the tissue samples were from the ileum, the same ileum- and colon-like disease subtypes of the disease were present.
Thus, it seems that the molecular programmes which control the gene expression in the cells of the two subtypes exist independently of patients’ ages or treatments histories. The researchers furthermore point out that the two subtypes were linked to different patterns and disease progressions. Those with a colon-like subtype were more likely to be characterised by gut inflammation, rectal disease and colon inflammation so severe that the colon had to be removed.
Researchers hope that in the future, healthcare providers will be able to diagnose which subtype a patient has from routine colonoscopies. By identifying which subtype a patient has, it will be easier for healthcare providers to initiate a more personalised treatment. Thus, it is the researchers’ wish that it will be possible to improve Crohn’s patients’ symptoms quicker and more efficiently in the future.
Sources:
1. http://www.nhs.uk/Conditions/Crohns-disease/Pages/Introduction.aspx
2. http://www.medicalnewstoday.com/articles/313508.php
