Stem Cells a Cure for Crohn's Disease?

University of Nottingham, November 30, 2007

A cure for Crohn's Disease could be found with the use of stem cells. Scientists are evaluating the efficacy of stem cell treatment on Crohn's Disease when they are used to 're-boot' the immune system.

The possibility of long-term remission for tens of thousands of people in the UK, and many more worldwide, is being investigated in a major clinical trial by University of Nottingham researchers. The experiments will involve taking stem cells from a patient's own body and using them as a form of treatment.

The first of it's kind to treat Crohn's, the study is currently recruiting patients for its Europe-wide trial. Most commonly affecting the colon and small intestines, the condition is a chronic ongoing disease. The main symptoms are weight loss, fatigue, diarrhea, and pain in the abdomen. These are caused by inflammation, deep ulcers and scarring to the wall of the intestine.

About 3,000 to 6,000 new cases are diagnosed each year, and currently, about 60,000 people in the UK suffer from the condition. Immune suppressant drugs, and steroids which can only be administered in the short term are current treatments. There is no cure for the disease.

But a cure for up to 50 percent of sufferers could be in the making according to Professor Chris Hawkey and colleagues Dr. Paul Fortun and Dr. Tony Shonde who are together, conducting the Nottingham-led stem cell therapy.

Professor Hawkey said: “People with severe Crohn’s have very poor quality of life and at the moment there is no cure for them. So what we are attempting to achieve with this trial is something really quite radical and ambitious — and could make a major difference to the lives of a lot of patients.”

Crohn's is first triggered in the body when individuals comes into contact with particular environmental stimuli. The immune system responds and the symptoms occur, which dramatically affect the lives of patients who suffers from the genetically predisposed disease.

Stem cells could take the immune system back to the state prior to the start of Crohn's symptoms by means of a "re-boot". To accomplish this, stem cells, which are the body's master cells, will be extracted from the patient and re-established in their bone marrow.

The study is called ASTIC – which stands for Autologous Stem cell Transplant International Crohn’s Disease trial. 48 volunteers from Canada, the Czech Republic and Switzerland, UK, Germany, Spain, Belgium, Italy, France, and Holland will be recruited into the study by Professor Hawkey and his team. All volunteers will be suffering from the most serious symptoms.

The trial will be featured on, 'What Can Science Do For Me', which is a television program that investigates potential new treatments for people suffering from serious medical conditions. Five people living with a range of chronic conditions includingCrohn’s, MS and Cystic Fibrosis are taken behind laboratory doors to find out just what science can offer them. The series started on the Community Channel on November 1st, and will run for five weeks.

Patients meet the scientists behind groundbreaking clinical trials and translational research across the UK and are introduced to state-of-the-art diagnostic techniques. Each person's individual journey is followed as they meet scientists working at the cutting edge of research into diagnosis, treatment and prevention of their particular condition — research which should ultimately help others with a similar diagnosis.

Now with most of his small intestines removed, Gareth has suffered from Crohn's disease for 21 years. In order to learn about pioneering treatments for his condition including stem cell therapy, he has taken his pain and fear and focused it towards making a television program called 'Gutless', which follows him around as he learns about treatments.

As part of the programme, Professor Hawkey also outlines another current study, which is investigating the use of hookworms to help in the fight against Crohn’s.

The tiny parasite could aid in the search for an effective long-term therapy in patients who suffer from a milder form of the disease. Necator Americanus, could help to reduce symptoms of Crohn's, and this is in the process of being confirmed by Professor Hawkey and his colleague Professor David Pritchard, with Dr. Fortun and Dr. Shonde.

Infestation is thought to ‘down-regulate’ the immune response, thus, scientists believe the gut parasite may be linked to levels of autoimmune diseases. In order to survive inside the gut for years at a time, the hookworm is able to reduce the immune response. Hookworms could be used as a potential new treatment for a number of conditions as long as the mechanism that allows it to control the immune system can be identified.

To see whether it can achieve positive results, patients are deliberately infected with a small number of gut parasites. The hookworm trial has already been initiated.

The Eli and Edythe Broad Foundation, a philanthropic organization based in California, and the Broad Medical Research Program have funded both the Crohn’s Disease and hookworm studies at The University of Nottingham.