Consider The Evidence: Med/Peds Journal Roundup

February 25, 2006

Crohn’s breakthrough: Have we had it wrong all along?

Filed under: crohns, IBD, immunity, lancet — medblog @ 2:43 pm

Lancet 2/25 – In what is being touted as a landmark study, Marks, et al. show evidence that Crohn’s disease is due to an immune deficiency rather than an autoimmune process. This controversial finding seems to contradict the evidence supporting the use of immunosuppressive therapy that has been the mainstay of treatment for years.

The study involved the biopsy of rectal mucosa from Crohn’s pts, UC pts, and healthy controls. Samples were taken from clinically unaffected tissue. Immune cell and cytokine markers were compared among the pre- and post- biopsy samples. The response was significantly lower in the Crohn’s group.

One of the most telling parts of the study involved the subcutaneous injection of heat-killed E. Coli. The Crohn’s patients had a significantly lower increase in bloodflow in response to the challenge – evidence that the defect is systemic, rather than confined to the bowel. The researchers conclude that the defect in Crohn’s is due to a defective neutrophil response to bacteria that results in a chronic inflammatory state.
Daniel JB Marks, Marcus WN Harbord, Raymond MacAllister, Farooq Z Rahman, Jodi Young, Bissan Al-Lazikani, William Lees, Marco Novelli, Stuart Bloom and Anthony W Segal, Defective acute inflammation in Crohn’s disease: a clinical investigation, The Lancet, Volume 367, Issue 9511, , 25 February 2006-3 March 2006, Pages 668-678.
(http://www.sciencedirect.com/science/article/B6T1B-4JBB33D-14/2/4c8a150f0c0d979e96c81f327398727f)

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7 Comments »

  1. Hi

    If you want to discuss Crohn’s a bit more please go to

    http://www.thepatientconnections.com/blog.asp?uid=24

    We are running a research blog on the subject and your comments and opinions would be greatly appreciated

    Thanks

    Belinda

    Comment by Belinda Shale — April 8, 2007 @ 6:41 am

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