Biologics for Inflammatory Bowel Disease Increase Risk for Melanoma

Been a long time since I posted.  Came across this article.  Here's an excerpt:

Patients with IBD had a higher incidence of melanoma than controls; this association was significant in patients with Crohn disease (incidence rate ratio, 1.45) but not in patients with UC (IRR, 1.13). Researchers observed a trend of increasing risk for melanoma in patients with IBD over time. In a nested case-control analysis, any use of a biologic anti–tumor necrosis factor (anti-TNF) agent was associated with an almost twofold increased risk for melanoma, unlike thiopurines or 5-aminosalicylic acid (5-ASA) medications, for which no associations were observed. The risk for NMSC was increased by almost twofold in patients who used any thiopurine, but was not significantly increased in patients who used anti-TNF agents.

Makes sense that there are side-effects of using biologics.

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.

Could Sucralose (Splenda) Be A Contributor?

Saw an interesting article that suggested that Splenda (sucralose) was potentially to blame for the rapid rise in IBD in Canada.

I've never historically eaten any foods with Splenda in them, but perhaps other artificial sweeteners have a similar effect on the gut.

An excerpt:

The theory that Splenda may be a culprit in the rise of inflammatory bowel disease (IBD) appears to be a reasonable one, echoing the results from a 2008 study published in the Journal of Toxicology and Environmental Health, which discovered that Splenda:

• Increases the pH level in your intestines, and
• Reduces the amount of good bacteria in your intestines by 50 percent!

Bilberries May Help Control IBD

Bilberries (or huckleberries) may help control symptoms of inflammatory bowel disease. Researchers in Europe suggest positive results (see article) from a study of colitis in mice. Blueberries are a close relative to bilberries, so they might serve as a more accessible alternative.

Here's an excerpt:

Bilberries, which are a close relative to blueberries, contain anthocyanins, pigments that have antioxidant, anticancer, and anti-inflammatory properties. Previous studies show bilberries are effective in the management of diarrhea, which is one of the main characteristics of inflammatory bowel disease.

Crohn's Disease Genes Linked to Multiple Illnesses

According to a study from the University of Edinburgh, apparently some of the genes linked to Crohn's Disease are also linked to breast and prostate cancer, Hodgkin's lymphoma, high cholesterol, and obesity. Obviously, if you're suffering from Crohn's, you're probably thinking ... "Oh man, what else is going to get thrown at me!". But it's important to know that your genes may cause other problems with your health and it lets you be on the lookout for them (along with taking preventative action).

Here's an excerpt from the article linked to above:

The study by the University of Edinburgh has found that genes responsible for Crohn’s disease are linked with other conditions including breast and prostate cancer, Hodgkin’s lymphoma, high cholesterol and obesity.

Knowing how diseases are genetically connected could aid efforts to develop medicines and potential side-effects could be predicted and avoided.

The Low FODMAP Diet

IBD and IBS must be becoming more widespread (or at least there must be more awareness about them), because I read an article in the Wall Street Journal about a new diet meant to address IBS. It's called the Low FODMAP's diet.

Here's an excerpt from the article:

The theory is that many people with IBS have trouble absorbing certain carbohydrates in their small intestines. Large molecules of those foods travel to the colon, where they are attacked by bacteria and ferment, creating the telltale IBS symptoms of gas, bloating, constipation or diarrhea.

A long list of foods—including dairy products, some fruits and vegetables, wheat, rye, corn syrup and artificial sweeteners—can potentially create such problems in susceptible people. Collectively, they're known as Fodmaps, an acronym that for stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.

The general theories behind this aren't anything new. In fact, they are very similar to the Specific Carbohydrate Diet in some ways. But if you look at what's "legal" vs. "illegal", there are some serious contradictions between the diets. I suppose that's not necessarily surprising, though, as IBS and IBD are different. But just interesting that one diet doesn't address both. I wonder if that hints to the cause at all?

At any rate, here's the graphic from the WSJ article that covers some of the low and high FODMAP foods:

Crohn's Disease, the Rise of Agriculture, and Gene Expression

Just read a really complicated article that went way over my head in Discover Magazine, but thought I'd share it as there are some interesting theories presented.

Here's an excerpt:

So what happened? The authors posit that the 503F allele was selectively favored at some point in the past, and flanking it were the Crohn’s disease risk elevating variants of IRF1 and IL5. All things equal it is best not to have a risk for this disease, but all things are not equal. If there was a strong enough selective pressure on the target, 503F, then the downsides of the fact that it came as a “total package” with some deleterious alleles would be irrelevant. Over a long enough evolutionary time the deleterious alleles would be purified through negative selection because recombination does break apart associations, but there’s a lot of reality which consists of being between beginnings and ends.

Basically, the idea is that agriculture put a selective pressure on the genome that brought along genes that increased risk of Crohn's disease. To put that in more plain words, the rapid change in environment caused by the rise of agriculture (e.g. living off of certain grains), put pressure on the natural selection of genes. Certain gene variants (mutations) were favored in the new environment and so flourished. Unfortunately, those positive gene variants (which helped humans deal with the benefits of agriculture) brought with them negative gene variants (which increased risk of disease).

Interesting theory. The writer that's critiquing the article doesn't completely agree with the conclusion, but definitely some interesting analysis.