IBD Less Common in Sunny States

I've blogged about this before, but there was a recent study that revealed that people who live in sunnier regions of the United States are less likely to develop IBD. It confirms previous research conducted in Europe that generated the similar results. The study followed over 200k participants that began the study without symptoms of IBD.

The basic explanation for this is Vitamin D. There's a strong role for Vitamin D in the immune response and IBD patients (including myself) often have low Vitamin D levels. So stop postponing that vacation to Hawaii already!

Here's an excerpt:

"A leading explanation for this north-south gradient in the risk of ulcerative colitis and Crohn's disease may be differences in exposure to sunlight, or UVB radiation, which is generally greater in southern latitudes," wrote Dr. Hamed Khalili, of Massachusetts General Hospital in Boston, and colleagues.

"UV radiation is the greatest environmental determinant of plasma vitamin D, and there is substantial experimental data supporting a role for vitamin D in the innate immunity and regulation of inflammatory response," they noted.

Why Pregnancy Pushes Autoimmune Diseases into Remission

A friend of a friend of mine has had Crohn's for many years. But when talking to her, she mentioned that during her pregnancy all her Crohn's symptoms completely subsided and she was in "remission". Why? This apparently is a common phenomenon for pregnant women with autoimmune diseases -- during pregnancy their diseases go into remission.

A new study from the University of Michigan may explain why. Apparently the expression of an enzyme called pyruvate kinase is reduced in immune cells in pregnant women. The reduction in this enzyme "dials-down" the immune system supporting the acceptance of the fetus.

An excerpt from the article:

In his search to explain the phenomenon, Dr. Petty knew to look for a metabolic pathway ormechanism with two characteristics. It had to "dial down" the intensity of the normal immune response, an action needed so that a pregnant woman does not reject the fetus, which has proteins from the father that are "foreign" to the mother. At the same time, such a mechanism must support cell growth needed by the developing fetus.

The activity of the enzyme pyruvate kinase–and its product, pyruvate–fills both roles: promoting cell growth while modifying the immune response. Because pyruvate kinase activity is depressed duringpregnancy, cell metabolism supports an increased production of lipids, carbohydrates, amino acids, and other substances that support cell growth.

This suggests an interesting alternative therapy or treatment option for the future (and I'm not suggesting that you just go get pregnant!). There may be a way to use this immune pathway in a drug therapy. It doesn't necessarily identify or address the root cause of IBD, but it could lead to another alternative therapy.

Teaching Kids to Cope with IBD

Saw this article about a study conducted at the University of Georgia with teenage girls suffering from IBD. They found that teaching the young girls "coping" and "community" skills had a positive impact on their physical symptoms. They also found that mental distress decreased -- as they called it "catastrophic thoughts" (pretty scary sounding if you ask me).

Here's an excerpt:

"We saw significant improvements in these adolescents' physical symptoms and coping strategies following treatment," said Ronald Blount, professor of clinical psychology at UGA and an author of the study. "Parents, who were also involved in the study, reported reductions in catastrophic thoughts related to their daughters' pain and improved behavioral reactions related to their daughters' physical symptoms. We aimed to teach parents to become coaches for their daughters to help them better manage their symptoms."

Inflammatory bowel disease is a pretty life changing illness, though, and one quite difficult to talk about with others (particularly if you're a teenager), so I can certainly appreciate how important it is to teach young people these coping strategies. Stress certainly may play a contributing role in the disease, so stress reduction strategies may be helpful. The next step for the researchers is to expand the study to a larger population.