Changing technologies benefit IBD sufferers

Scientists’ understanding of inflammatory bowel disease (IBD) has increased recently as a result of some interesting developments. As AGA member, of the Digestive Health Center of Michigan states, not only have there been "tremendous changes in the last three to five years," we can also expect great changes in the near future. Doctor calls this a "very optimistic time" for the diagnosis and treatment of IBD. So what’s on the horizon for those who suffer from Crohn’s disease and ulcerative colitis? Just in the past few years, new technology has changed the way IBD can be diagnosed. The most common basis for an IBD diagnosis remains colonoscopy after a small bowel test. However, colonoscopies themselves have changed recently.

Many doctors, also use complimentary tests like wireless capsule endoscopy – a camera you swallow like a pill that goes through your digestive system – to evaluate the small intestine for Crohn’s disease. This kind of innovative technology is just one of the many ways IBD treatment and diagnosis are being imposed today. Doctors are most excited about the many emerging biologic therapies for IBD. As the knowledge f the etiology (cause or origin) of IBD diseases, more targeted effects will be possible to interfere with the disease. At the 2004 Digestive Disease Week – the world’s largest annual conference of gastroenterologies – exciting innovations and discoveries were discussed concerning the biologic treatment of IBC. We can think of biologic therapies as falling into two categories – high-tech, and low-tech.

The high-tech category includes scientifically manufactured proteins such as infliximab, which kills monocytes and T cells to combat IBD. Monocytes – large white blood cells that turn into macrophages – become inflamed in people afflicted with IBD, and can be killed to reduce suffering. Specialized mucosal T cells can also cause problems, as their role in regulating normal immune responses in the intestine can cause chronic inflammation. Exciting new research in IBD has focused on adalimumab – another high-tech protein. Adalimumab is an antibody similar in many ways to infliximab, with an important distinction: It appears likely that patients may be able to administer adalimumab to themselves.

In recent studies, adalimumab was effective and well-tolerated by test subjects – including those who had developed intolerance toward infliximab prior to the study. Many studies are still necessary to determine the correct dosage and clarify the side effects of adalimumab, but it seems likely that an alternative to infliximab may be forthcoming. The second category of biologic therapies is low-tech, and there is exciting news from that end of the spectrum as well. Specifically, a group of scientists at the University of Iowa have been investigating helminth therapy for both Crohn’s disease and ulcerative colitis – a helminth is a type of parasitic worm. Their studies involve giving patients a type of helminth ova that does not cause disease in humans.

These helminthes favorably effect the immune system in IBD patients to decrease inflammation. In fact, IBD is very rare in regions of the world where helminthes are commonly found. For both patients with Crohn’s disease and ulcerative colitis, the treatment was effective and well-tolerated. There were no instances of complications in the studies, but larger experiments with greater numbers of patients are needed to confirm these promising initial results. Whether it’s a new high-technology in the form of tiny cameras and promising proteins, or new uses of low-technology in the form of helminth therapy, it is an exciting time in the study of IBD.