Caring for Crohn's & UC

Microbiome & IBD: The future of treatment?

October 17, 2014 at 2:57 pm Rebecca K. 1 comment

When I sat down with Rick Geswell, president & CEO of the Crohn’s & Colitis Foundation of America (CCFA) in September, I knew the conversation would focus primarily around CCFA’s Genetics and Microbiome Initiative. I had seen the video that CCFA put out but beyond that, knew very little about the two initiatives and definitely had no idea how microbiota are linked to Crohn’s disease and ulcerative colitis. But what I learned about it is fascinating.

Gut microbiota (also known as gut flora) are the individual organisms that live in our gut. According to Gut Microbiota Worldwatch (the public information service from the European Neurogastroenterology and Motility Society), gut microbiota contains trillions of microorganisms and at least 1,000 different specials of bacteria and more than three million genes. In fact, there are 150 times more bacterial genes in the body than human genes. Therefore, the microbiome is a compilation of all that lives in our gut (flora, bacteria, genes, etc.) and has an impact on our body.

CCFA began studying microbiome and its link to IBD about six years ago. At the time, Rick says they had limited knowledge about microbiome.

“We knew some bacterial names and had an idea that some had an impact on patients with inflammatory bowel disease. Unfortunately, we couldn’t really study it at the time because we didn’t have the tools or technology,” Rick said.

The CCFA Board wanted to do something to study the gut in order to learn why some people get the disease and others don’t. Scientists were anxious to study that so CCFA went out and raised money to begin studying the microbiome.

CCFA has raised over $8 million towards its Microbiome Initiative, and is continuing to seek funding for this important project.

According to CCFA’s website, the Microbiome Initiative is being conducted in partnership with the Center for Genome Studies at Washington University in order to develop greater understanding of the role of gut microbes (bacteria, viruses, etc. that are found normally in the intestines) in digestive health and inflammatory bowel diseases. Using the latest generation of massively parallel DNA sequencers and sophisticated computational methods, the initiative studies the complex role that intestinal microbial communities play in digestive health and disease.

Rick says in the six years since the initiative was launched, we have made significant progress.

“There are diagnostic tools in the process of coming out. We know a lot more now about the bacteria and its interaction with our genes than previously. We know that the bacteria actually, in combination with genetic predisposition, creates the IBD environment in a patient.”

For example, we know that we need both good and bad bacteria in our gut- they balance each other out and create a healthy environment in our digestive tract.

“Sometimes the bad bacteria has a bloom and overtakes the good bacteria- you feel crummy and it may trigger disease. Sometimes the good bacteria get out of control and the bad can’t do its job, and you feel crummy. In a healthy person, you will have diarrhea and indigestion. But in a person with inflammatory bowel disease, this imbalance sends you into a flare. The microbiome exists so we can identify which bacteria gets out of control and if there are methods that can be used to interfere with those bacteria [so that you can avoid a flare and stay healthy],” said Rick.

The reaction in the gut is also due to genetics. There are more than 163 genes identified with a link to IBD so far. However, with so many gene arrays and bacteria that exist, identifying the combination that triggers IBD isn’t one that is easy to identify. One interesting thing Rick noted is that there is a gene that has commonality between Crohn’s disease and Parkinson’s. When you have one, it protects you against the other. I’ll go more in depth in the Genetics Initiative and key findings to date in a later blog post.

Here are some highlights and findings of the Microbiome Initiative to date:

• People carrying different IBD genes have different compositions of gut bacteria. A person’s genes can therefore affect which gut bacteria they host.
• There are more than 20 families of bacteria implicated in disease progression.
• Patients who develop structures have certain microbial populations.

The Microbiome Initiative ultimately hopes to yield new strategies to treat and prevent IBD by targeting specific microbiota (along with genes) found in patients with Crohn’s disease and ulcerative colitis. Additionally, it hopes to develop and use bacterial profiles to predict the course of disease in an individual patient with IBD – the aggressiveness of disease, risk of complications, and response to treatment.

For more information about the Microbiome Initiative, visit www.ccfa.org.

Stay tuned for more blog posts from my interview with Rick about CCFA, its programs and initiatives, and the future of IBD research and treatment!

Entry filed under: General Disease, Genetics, IBD News, Interviews, Treatment. Tags: CCFA, Colitis, crohn's, Crohn's and Colitis Foundation of America, crohn's disease, Crohn's Sucks, genetics, uc, ulcerative colitis.