Crohn's Disease on the Rise in Scotland

Saw an article in BBC News about how the incidence of inflammatory bowel disease has doubled in Scotland since 1980. It's unclear why there has been such an increase in that particular region relative to other European countries. But at this point, Scots are apparently the most likely Europeans to develop Crohn's Disease.

Antibiotics in Infancy Potentially Linked to IBD Risk

A small study showed that there might be an increased risk of IBD for infants that are given antibiotics in their 1st year of life. The study compared 36 children with IBD with 360 children that did not have IBD. 60% of the group with IBD had been given antibiotics compared to only 40% for the non-IBD group. The difference was even more pronounced for boys than girls. The study suggests a possible root cause or causative agent in the development of the disease. But again, this was a very small study, so this just suggests areas for additional research.

Anti-TNF Decreases Presence of MAP

I only saw the abstract of this one. There was a study that found that taking anti-TNF drugs, in this case infliximab (i.e. Remicade), reduced the occurrence of mycobacterium avium paratuberculosis (MAP) bacteria in people suffering from Crohn's. Specifically, they just measured the change in MAP antibodies in the blood, but it would suggest that Remicade supported the body's fight against any MAP infection. I've had a couple posts on MAP, so I like to monitor research in this area. Interesting finding that supports the efficacy of these drugs (although admittedly I don't take them).

Discovery Prompts New Theory on Cause of Autoimmune Diseases

Saw an article in ScienceDaily about a new theory on the cause of autoimmune diseases, including Crohn's Disease. Researchers discovered a protein (or peptide) fragment that's capable of causing diabetes in mice. The basic hypothesis is that the unusual introduction of these peptides allows errant T-cells to escape the thymus and make there way to other parts of the body where they initiate immune responses associated with autoimmune diseases. These errant T-cells that are autoreactive (or that react to your body's own cells) are normally deleted by the immune system. However, the introduction of these rare peptides causes the deletion procedure to not work properly.

Here's an excerpt:

In the April 23, 2010, issue ofImmunity, Drs. Brian Stadinski, John Kappler and George Eisenbarth propose that the unusual and rare presentation of protein fragments (peptides) to the immune system allows autoreactive T cells to escape the thymus and trigger autoimmune disease. The findings could lead to a new strategy for preventing type 1 diabetes.

"The immune system normally deletes dangerous, autoreactive T cells that recognize 'self' peptides, which are a normal part of the organism," said Dr. Kappler, Professor of Immunology at National Jewish Health. "We believe autoreactive T cells in diabetes and other autoimmune diseases escape destruction in the thymus because they never see these poorly presented peptides there. But the T cells do encounter those peptides elsewhere in the body and trigger an autoimmune attack."

Pretty fascinating if the theory is correct. It could also suggest very new areas of research for treatment options.

Olive Oil Good, Aspirin Bad

Saw results of two different studies. One was about how Olive Oil (specifically oleic acid) helps to prevent inflammatory bowel disease. The second was about how aspirin increases the risk of Crohn's Disease by five times!

Recent Review of Diet's Role in Inflammatory Bowel Disease

Came across this recent survey (PDF) of the different dietary causes and treatments of inflammatory bowel disease, including Crohn's Disease. Nice article that touches on several different dietary alternatives and their efficacy (when tested in controlled studies). Here's the abstract of the article (cut-and-pasted):

Many studies have looked at connections between diet, etiology, signs and symptoms associated with inflammatory bowel disease (IBD). Although these connections are apparent to clinicians, they are difficult to prove qualitatively or quantitatively. Enteral feeding and polymeric diets are equally effective at bringing about remission in Crohn’s disease (CD). Parenteral feeding is also effective, although none of these methods is as effective as corticosteroid therapy. However, enteral feeding is preferred in the pediatric population because linear growth is more adequately maintained via this route. Exclusion diets in patients brought into remission using an elemental diet have been shown to maintain remission for longer periods. Studies that aim to isolate culpable food groups have shown that individuals react differently on exposure to or exclusion of various foods. The commonly identified food sensitivities are cereals, milk, eggs, vegetables and citrus fruits. Studies that have looked at gut mucosal antigen behavior have shown higher rectal blood flow, in response to specific food antigens, in those with CD over healthy subjects. Exclusion of sugar shows little evidence of amelioration in CD. Omega 3 fatty acids show promise in the treatment of IBD but await larger randomized controlled trials. Patients frequently notice that specific foods cause aggravation of their symptoms. Whilst it has been difficult to pinpoint specific foods, with advances in the laboratory tests and food supplements available, the aim is to prolong remission in these patients using dietary measures, and reduce the need for pharmacotherapy and surgical intervention.

Of course the conclusion of the study basically just says "we need to do more research", but that's to be expected.

PPAR-gamma Protein Key to Inflammatory Bowel Disease

Researchers have found a new potential treatment option for inflammatory bowel disease. The protein PPAR-gamma was found to help restore the body's natural defenses against gut infections from bacteria and could be used as a treatment for Crohn's Disease.

Here's an excerpt:

Samples taken from the colons of humans diagnosed with Crohn's disease also show reduced levels of the antimicrobial peptides, or defenses, regulated by the PPAR-gamma protein, they wrote.

Chamaillard said foods or diets containing conjugated linoleic acid (CLA) can also boost PPAR-gamma activity and have been shown to improve colitis and colitis-associated cancer.

CLA is primarily found in milk and meat products.

"In the short-term, managing the disease is what we are looking at, but it may also be that in the future we could develop a way of stopping it," Chamaillard said.

But he added that curing Crohn's disease would mean being able to identify those at highest risk before they contracted it and then being able to boost PPAR gamma-related defenses to ward it off -- both areas that would need more research.

So how could you add more CLA to your diet? I checked out the CLA Wikipedia page and found the following:

Of all foods, kangaroo meat may have the highest concentration of CLA.^[34] Food products (e.g. mutton and beef) from grass-fed ruminants are good sources of CLA, and contain much more of it than those from grain-fed animals.^[35] In fact, meat and dairy products from grass-fed animals can produce 300-500% more CLA than those of cattle fed the usual diet of 50% hay and silage, and 50% grain.^[36]

Eggs are also rich in CLA, and it has been shown that CLA in eggs survives the temperatures encountered during frying.^[37]

Some mushrooms like Agaricus bisporus and Agaricus blazei, are rare vegetable sources of CLA.^[38][39]

Very exciting to see research being done (and producing results) regarding natural methods of treating Crohn's. I'm looking forward to seeing how this research advances. In the meantime, stock up on the kangaroo burgers.