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Crohn’s and Bones: How Your Marrow May Improve Your Digestion

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Taking a corticosteroid anti-inflammatory prescription medication like Budesonide is just one of the traditional Crohn’s disease treatments. While this often-debilitating condition is unpreventable and incurable, new research shows innovative treatment methods are on the horizon. Before long, doctors may be able to use your own bone marrow cells to improve your agonizing symptoms.

Old Crohn’s “Treatments” Are Changing

Crohn’s disease, an inflammatory bowel disease (IBD), can cause severe abdominal cramping and pain, frequent diarrhea, rectal bleeding, fever, loss of appetite, malnutrition and weight loss. It may affect your entire digestive tract including your mouth, esophagus and stomach. Many patients need bowel resections eventually, but Crohn’s disease recurs often after surgery. Luckily, medical research is focusing on new therapy development. Doctors have been treating life-threatening hematological conditions successfully with blood and bone marrow cells for decades. Now research shows that using cells from the patient’s own immune system is becoming a safe, effective Crohn’s disease treatment. T regulatory cells, or Tregs, convey information to your immune system to prevent it from attacking itself. By modulating your immune system, these cells can calm intestinal inflammation. Based on the following studies, this treatment could help you live more comfortably with Crohn’s disease in the near future.

A Revolutionary Discovery About Bone Marrow

A Michigan State University study found bone marrow, a large highly active and responsive tissue, mirrors the havoc inflammatory bowel disease wreaks on the digestive tract. When study co-author Pam Fraker, MSU University Distinguished Professor of biochemistry and molecular biology, induced colitis in mice, she was surprised at how significantly and swiftly their bone marrow changed. It reflected common colitis symptoms of swelling, anemia and unhealthy increases in monocyte and neutrophil cells that exacerbate excessive bowel inflammation. Fraker and her colleagues concluded doctors can treat disorders of the gut potentially through bone marrow. If they can reduce bone marrow’s ability to produce inflammatory cells, they could diminish the severity of Crohn’s disease. Such a breakthrough could limit the damage the disease causes and decrease the number of patients needing surgery.

The Amazing Remission Rate Achieved With New Treatment

“Immunoablation and repopulation of the bone marrow by uncommitted stem cells has excited a lot of interest in Crohn’s crohns2disease lately,” said Christopher Hawkey, M.D., from the University of Nottingham. “Some of the case reports are so dramatic that it’s reasonable to talk about this being a cure in those patients.” Hawkey led an Autologous Stem Cell Transplantation International Crohn’s Disease (ASTIC) trial group study. He and his research team evaluated self-renewing stem cell transplantation in patients with moderately to severely active Crohn’s disease that was resistant to treatment. All study participants underwent stem cell mobilization with cyclophosphamide and filgrastim. Researchers divided patients into two random groups. The treatment group had immediate stem cell transplantation at one month while the control group had delayed transplantation at 13 months. After a year, Hawkey assessed the remaining members of both groups. Objective endoscopic findings were substantially better in the stem cell treatment group than the control group. On the Simple Endoscopic Score for Crohn’s Disease, the mean lower gastrointestinal score fell from 13 to four in the treatment group. It remained unchanged in the control group. The decrease in median Crohn’s Disease Activity Index score was greater in the stem cell recipient group than the control group (approximately 165 points compared to just 50). Two-thirds of the treatment group participants were able to discontinue immunosuppressive drugs and steroids after one year compared to only 15 percent of the control group patients. Nearly 50 percent of participants achieved clinical remission. Researchers concluded that hematopoietic stem cell transplantation can be a highly effective treatment method for patients with resistant Crohn’s disease.

Other Ongoing Bone Marrow Trials

In a groundbreaking FDA-monitored clinical trial, physician-researchers are harvesting bone marrow cells from 18- to 65-year-old Crohn’s disease patients. Then they’re manufacturing personalized cells to target and control Crohn’s inflammatory mechanisms. Subra Kugathasan, M.D., Marcus Professor of pediatric gastroenterology at Emory School of Medicine and a physician with Children’s Healthcare of Atlanta, is leading the clinical trial at Emory Personalized Immunotherapy Center (EPIC). Deriving mesenchymal stromal cells from each patient’s own bone marrow instead of an anonymous donor decreases the rejection risk. These cells have the ability to generate a local immunosuppressive microenvironment, which leaves other necessary immune responses intact. While other trials rely on bovine or other non-human growth factors, EPIC’s cell preparation process uses only human protein extract. The study team manufactures cell products on-site in EPIC’s dedicated pharmaceutical-grade facility. Bone marrow recipients receive fresh cells instead of less effective frozen ones shortly after harvest. The goal of this trial is to reduce intestinal flare-ups and decrease long-term damage.

The Future of Crohn’s Treatment

As research continues, bone marrow transplant treatment may become available to you. Ask your doctor if this upcoming methodology is a viable option for your specific medical situation. If so, be on the lookout for clinical trials and treatment availability in your area. Until you can benefit from a bone marrow transplant, continue taking your Crohn’s prescriptions. By controlling your gastrointestinal tract inflammation, present and future treatments can help you function as normally as possible.



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