Discovery of Two Subtypes of Crohn’s Disease Could lead to Better Treatment

Crohn’s Disease is a condition that affects about one million people in the U.S. It is a long-term condition and its sufferers’ experience inflammation of their digestive systems. There is no cure, but the disease can often be managed with medication. However, most people who suffer from the disease will need surgery at some point in their lives to correct the damage done to their digestive system, whilst approximately 39% will require surgery more than once.

Crohn’s is notoriously difficult to manage because not everyone with the disease responds to the same treatment in the same way. However, researchers from University of North Carolina School of Medicine have recently discovered two subtypes of the disease. This may help to explain why the disease acts differently for different people.

The study was conducted by senior authors Dr. Shehzad Z. Sheikh, Ph.D. and Teddy Furey, Ph.D. They analyzed the colon tissue from a group of 21 people with the condition who had recently had surgery. They discovered that there were two distinct gene expression patterns among the patients. According to Furey ‘Although we saw a difference between the Crohn’s samples and samples from people without Crohn’s, we saw an even greater difference at the molecular level between these two subsets of the Crohn’s samples – the healthy tissue from Crohn’s patients and the inflamed samples from Crohn’s patients.’

For one group, the gene expression resembled healthy colon tissue, whilst for the other group, it was similar to patterns found in the ileum (part of the small intestine, which is often the first area to be affected by Crohn’s). The team also observed differences in a way that the affected cells are programmed – their epigenetic state.

The researchers followed up their study by conducting the same examination on more than 200 children who had recently been diagnosed with Crohn’s Disease but had never yet been treated. They found the same differences as they had found in the adult patients who had undergone surgery.

Significantly, the two different subtypes that the researchers found are linked to a different onset pattern of the disease. The researchers hope to produce a test for diagnosing the subtype and specifically treating it. According to Sheikh ‘We hope one day to be able to test Crohn’s patients for the subtype of the disease they have, and thus determine which treatment should work best. The idea is to find the best therapeutic course for each patient as quickly and efficiently as possible.’

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