Patients with Crohn’s disease often have to deal with the narrowing or blocking of the intestines caused by intestinal fibrosis. This type of narrowing occurs when tissue, responding to an injury or damage, repairs the spot by developing fibrous connective tissue.
The fibrous tissue does not act like normal tissue and can cause problems with proper movement through the GI tract, most frequently in the form of strictures. While there is surgical treatment for these strictures, there are no effective medications to treat the condition, although some are being studied.
A study published in Science Immunology in September 2016 looked at mice with a certain gene mutation, or Rora-deficient mice, that prevented them from developing fibrosis. What researchers discovered was the mice not only failed to develop fibrosis but the gene mutation also switched off a hormone receptor responsible for the inflammatory cells driving the fibrosis to begin with. The gene mutation was linked to a hormone receptor that signaled the inflammation to begin.
The significance of this new data for the future of Crohn’s (and other fibrosis-related conditions like liver cirrhosis or scarring from heart attacks) is huge. Potential studies will look into whether medications can be developed to block the hormone receptor itself and prevent the inflammation and fibrosis from happening in the first place. This is one of many studies showing how genetics influence whether a Crohn’s patient develops strictures or not. There are some medications being tested to improve the strictures, too.
For patients with Crohn’s, this could mean preventing one of the most common reasons for surgery. With 75 percent of Crohn’s patients eventually needing surgery, eliminating this cause could greatly improve the cost of health care and quality of life for patients.
This research is still in the early stages and studies will have to be conducted on humans and repeated to insure the accuracy of the results. Medications, once developed, will also have to be studied to determine the effective dose needed to provide the desired results, as well as to determine any side effects or contraindications for taking the medication.
But the outlook for preventing fibrosis and stricture in Crohn’s disease in the future is promising.
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Jennifer Rackley is a nutritionist and mother of three girls. Two of her children have dealt with acid reflux disease, food allergies, migraines, and asthma. She has a Bachelor of Science in dietetics from Harding University and has done graduate work in public health and nutrition through Eastern Kentucky University. In addition to writing for HealthCentral, she does patient consults and serves on the Board of Directors for the Pediatric Adolescent Gastroesophageal Reflux Association.