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Largest Microbiome Study on Newly Diagnosed Patients Gives Insight Into Crohn’s Disease and Shows Antibiotic Treatment May Worsen Disease
New York, NY – March 12, 2014 – An important new study funded by the Crohn’s & Colitis Foundation of America (CCFA) and published in the March 12 issue of Cell Host & Microbe, reveals several important findings that identify the microbiome in early-onset Crohn’s disease and highlight particular microbes that are increased or decreased in abundance in the disease. Human genetics studies had previously pointed to pathways in host-microbe interactions that shaped the genetic architecture of inflammatory bowel disease, and this study now identities those microbes. Importantly, the researchers also found that use of antibiotic treatment in children with Crohn’s disease results in worsened dysbiosis, or imbalance of bacteria.
“These results identify the association of specific bacterial taxa with Crohn’s disease, provide opportunities to mine the CD associated microbiome to develop diagnostics and therapeutic leads.,” said senior author Ramnik Xavier, MD of Massachusetts General Hospital and the Broad Institute of MIT and Harvard.
In 2008, the Crohn’s & Colitis Foundation of America sponsored the RISK Stratification Study to establish a well-characterized inception cohort of children with Crohn’s disease, in which almost 1200 new-onset patients from 28 pediatric gastroenterology centers in North America were enrolled before onset of treatment. Researchers took biopsies from 447 individuals with new-onset Crohn’s disease and 221 nonaffected individuals at multiple locations along the gastrointestinal tract and then looked for differences between the two groups. They also validated their methods in additional individuals, resulting in a total of 1,742 samples from pediatric and adult patients with either new-onset or established disease.
“This unprecedented study is significant for a number of reasons,” said R. Balfour Sartor, M.D., CCFA Chief Medical Advisor and Midget Distinguished Professor of Medicine, Microbiology & Immunology, and Director of the UNC Multidisciplinary IBD Center. “It’s the largest multi-cohort of its kind and lays the foundation for both better diagnosis and understanding of these incredibly complex diseases.”
Highlights from the study include:
• Microbiota co-occur in two groups of organisms, increased or decreased in CD
• Rectal biopsies are a robust disease predictor, irrespective of disease location
• Fecal samples collected at onset of disease do not reflect alterations of intestinal lining bacterial communities
• Antibiotics contribute to an imbalance of intestinal bacteria
Known collectively as inflammatory bowel diseases (IBD), Crohn’s disease and ulcerative colitis affects 1 in 200 people in the USA and Canada. They are painful, medically incurable diseases 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 and weight loss. Many patients require numerous hospitalizations and surgery. The average delay in diagnosis is 1-3 years and the average patient is misdiagnosed twice.
“Genetic discoveries and insights into the microbiome offer a window into early events that contribute to disease onset. Using genomic tools, we can gain real insight from these observations and find clues to new therapies,” said Dr. Xavier. “These are common disorders with bad consequences if not detected and treated early. If we can begin to change that, we can really make a difference in the lives of our patients.”
Crohn's disease and ulcerative colitis are painful, medically incurable illnesses that attack the digestive system. Some 1.4 million American adults and children suffer from Crohn's disease or ulcerative colitis. For more information, visit www.ccfa.org, call 888-694-8872, like us on Facebook, find us on LinkedIn or follow us on Twitter.
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