Crohn's Disease: Promising New Findings Thesis

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The study supports the findings of the recent NF-kB research given that infliximab neutralizes an inflammation-causing protein called tumor necrosis factor alpha. This protein regulates "a common inflammation pathway that just happens to be important in Crohn's disease," suggesting that a specific, targeted molecular approach to treatment may be more helpful for Crohn's patients than steroids (Seppa 2008)

Future drugs, however, could directly address the problems regarding NF-kB, rather than simply treating the symptoms of inflammation. "NF-kB acts as a survival signal for cells. Without the molecule cells are much more likely to die and this is what happened in the intestines of... [the] mice; individual epithelial cells died disrupting the gut lining. Through these gaps bacteria could penetrate the intestinal wall. Right behind the gut epithelium lie cells of the intestinal immune system, the biggest immune system of our body. It detects the invading bacteria and generates a strong immune response to fight off the invaders. In the process of combating the bacteria, the immune cells secrete a cocktail of signals that bring about the symptoms of inflammation.

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..Inflammatory signals also reach the epithelial cells that due to the lack of NF-kB are very sensitive to them and die. The death of more epithelial cells creates bigger gaps in the gut lining so that more bacteria enter. The result is a constant immune response leading to chronic inflammation" ("Researchers Identify Molecular Basis of Inflammatory Bowel Disease," 2007, European Molecular Biology).

The finding that defective NF-kB signals in the gut epithelium initiates the outbreak of inflammation involved in Crohn's disease could produce more effective, specific, and targeted drug treatments without, hopefully, the side effects of steroids. It could enable patients to get treatments before the death of epithelial cells becomes chronic and life altering. Although still in its nascent stages, this may ultimately be more an effective approach to treat Crohn's than either drugs or surgical removal of the diseased tissue from the gut, neither of which produces long-standing and permanent cure.

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