2024-01-12 13:32:39
Inflammatory bowel disease (IBD) is a chronic, life-altering condition that is increasing dramatically globally. It is extremely difficult to treat and many people find that the treatments we have simply do not work for them.
Over the past 30 years, there has been an almost 50% increase in cases, now affecting around 5 million people. The disease should not be confused with irritable bowel syndrome (IBS), which is a condition that affects the digestive system; IBD is more serious.
The term is used to describe two serious diseases called Crohn’s disease and ulcerative colitis.
More women are diagnosed with Crohn’s disease, while more men are affected by ulcerative colitis.
People with IBD may experience a variety of symptoms, ranging from diarrhea and blood in the stool to weight loss and stomach pains. On paper, this may not seem worse than mild food poisoning; However, this is not a normal stomach upset.
The experiences are often extreme; People with IBD can suffer excruciating pain and, in some cases, require surgery to remove parts of the intestine. This is done by redirecting the intestine to a hole in the abdomen, where stool is collected in a colostomy bag.
However, we still do not fully understand the cause of IBD.
The impact of inflammation
The main symptom of IBD is excessive, uncontrolled inflammation, a sign that normally appears when the body fights an infection.
Although inflammation is an important aspect of our immune system, in IBD it occurs when the body is not under attack. Since we don’t know what causes this overreaction, treatments are limited to controlling the derailed immune system.
Inflammation is controlled by cell signaling. Our cells detect bacteria using receptors that attach to parts of those bacteria. This activates the receptor, causing it to send a signal to proteins, and each protein sends more signals, creating a signaling cascade. This is what tells the body that it is under attack.
Many treatments follow the strategy of intercepting signals and preventing the signal cascade from starting. However, for many people they are not effective.
Scientists are trying to target a different protein network, called NOD2, that is often out of control in people with IBD but is not the target of current treatments.
One protein, called RIPK2, seems a promising target since it is only found in this network.
Researchers at the European Molecular Biology Laboratory are investigating its structure to help scientists design a new drug that blocks the signals of this protein.
The importance of the microbiome
Another inspiration for new treatments comes from the bacteria that reside in our intestines. This community of bacteria, called the gut microbiome, has been associated with all types of health conditions, from asthma to obesity.
Gut bacteria work closely with our body and play a vital role in digesting food and controlling our immune system.
In a healthy person, there is a delicate balance between intestinal bacteria and the immune system. Disruption of this balance can lead to illnesses, ranging from minor discomfort to more serious long-term conditions.
Researchers are trying to understand how our bodies interact with gut bacteria and what changes when people develop IBD.
The gut microbiome is an ecosystem. Just as in a forest there are animals that eat different things, microbes can form a food web. Some bacteria consume one type of food, while others feed on others.
Some depend on other bacteria’s waste following they have eaten. Alteration of the gut microbiome is now believed to be a hallmark of IBD and contributes to its development and progression.
It’s a chicken and egg situation. Is there any change in the bacterial and food network that alters our body? Or does something else in the body, like our immune system, change the food web, subsequently limiting which bacteria can grow?
Scientists aren’t sure of the answer.
Instead of trying to figure out which happens first, a team at the Hudson Institute of Medical Research in Australia is focusing on investigating which interactions in the food web are most affected in IBD.
This might help scientists prioritize certain gut bacteria, or their food source, to restore microbiome balance and improve patients’ symptoms.
Hopefully, this specialized targeting of the microbiome will lead to more effective and long-lasting treatments.
Although we still have a long way to go before these treatment ideas become a reality, it is a step in the right direction.
Targeting a new signaling pathway might help control inflammation in more patients. And studying the microbiome might reveal how we can reverse the changes associated with IBD.
As key features of IBD, these advances might allow doctors to stop the disease in the early stages and reduce complications.
*Falk Hildebran is a Bioinformatics researcher, Quadram Institute, United Kingdom. Katarzyna Sidorczuk is a research scientist in Metagenomics, Quadram Institute. Wing Koon, is a PhD student in Bioinformatics, Quadram Institute.
*This article was published on The Conversation and reproduced here under the creative commons license. Click here if you want to read the original version (in English).
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BBC-NEWS-SRC: https://www.bbc.com/mundo/articles/cl4e32zkn40o, IMPORTING DATE: 2024-01-03 11:52:04
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