Early findings from a major research initiative of the Crohn’s & Colitis Foundation of America (CCFA) suggest that specific bacteria play a central

role in Crohn’s disease and ulcerative colitis (UC), also known as inflammatory bowel diseases (IBD). The evidence raises the possibility of developing new treatments to target the gut microbiome—the "ecosystem" of microbes populating the intestines—linked to the development of IBD.

Understanding the role of the gut microbes is the focus of the CCFA Microbiome Initiative. "This research is beginning to tell us about how some 'bad' bacteria are specifically linked to IBD, IBD families, and disease flares," comments Jonathan Braun, MD, PhD, of the David Geffen School of Medicine at UCLA. "We're still just at the beginning, but this line of research opens the possibility of manipulating the immune system and the balance of good and bad bacteria to influence the course of IBD."

The CCFA Microbiome Initiative—coordinated with another major research program, the CCFA Genetics Initiative—represents an effort to understand the interrelated microbial and genetic factors involved in Crohn's disease and UC. Researchers working on the Microbiome Initiative recently announced initial results of a three-year study, providing valuable new insights into the differences in the gut bacteria related to IBD.

The results show significant differences in the intestinal bacteria of people with and without IBD. What's more, those bacterial populations change when patients with Crohn's disease or UC experience a symptomatic worsening, or "flare" of their condition. Preventing such flares is an important goal of treatment for IBD.

Highlighting the complex interplay between the microbiome and genetic factors, the study also shows that unaffected family members of patients with IBD had the "same basic profile" of gut bacteria. Research from the CCFA Microbiome Initiative has already led to new tests to determine whether an individual has a microbial population associated with IBD.

The links between gut bacteria, risk of IBD, and IBD flares raise the possibility of monitoring the microbiome and altering it to prevent or treat IBD flares. "For example, patients could receive medications to block specific enzymes, or dietary choices—possibly including probiotics—to stimulate a healthier microbiome," says Dr Braun. "However," he adds, "a great deal more research will be needed to identify the most promising treatments, and design studies to evaluate their benefits for people living with IBD."

Ultimately, the combined work of the CCFA Microbiome and Genetic Initiatives may lead to the development of individualized therapy for IBD—targeted to the individual's genetic background, gut bacteria, and individual disease course.

"Researchers working on the Microbiome and Genetics Initiatives are making discoveries with real potential to lead to new treatments that can improve the lives of patients and families affected by IBD," comments Caren A. Heller, MD, MBA, the Chief Scientific Officer of the CCFA. "We're optimistic that these lines of research will lead to a better understanding and improved clinical management of Crohn's disease and ulcerative colitis in the not-too-distant future."

Crohn's disease and ulcerative colitis are painful, medically incurable illnesses that attack the digestive system. Crohn's disease may attack anywhere along the digestive track, while ulcerative colitis inflames only the large intestine (colon). Symptoms may include abdominal pain, persistent diarrhea, rectal bleeding, fever, fatigue and weight loss. Many patients require hospitalization and surgery. These illnesses can cause severe complications, including colon cancer in patients with long-term disease. Some 1.4 million American adults and children suffer from Crohn's disease or ulcerative colitis.

Source: The Crohn's & Colitis Foundation of America,

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