by Amy Norton, Healthday Reporter
But both trials were small and more research is needed.
(HealthDay)—Two experimental therapies might help manage the inflammatory bowel disorder Crohn's disease, if this early research pans out.
In one study, researchers found that a fecal transplant—stool samples taken from a healthy donor—seemed to send Crohn's symptoms into remission in seven of nine children treated.
In another, a separate research team showed that stem cells can have lasting benefits for a serious Crohn's complication called fistula.
According to the Crohn's & Colitis Foundation, up to 700,000 Americans have Crohn's—a chronic inflammatory disease that causes abdominal cramps, diarrhea, constipation and rectal bleeding. It arises when the immune system mistakenly attacks the lining of the digestive tract.
A number of drugs are available to treat Crohn's, including drugs called biologics, which block certain immune-system proteins.
But fecal transplants take a different approach, explained Dr. David Suskind, a gastroenterologist at Seattle Children's Hospital who led the new study.
Instead of suppressing the immune system, he said, the transplants alter the environment that the immune system is reacting against: the "microbiome," which refers to the trillions of bacteria that dwell in the gut.
Like the name implies, a fecal transplant involves transferring stool from a donor into a Crohn's patient's digestive tract. The idea is to change the bacterial composition of the gut, and hopefully quiet the inflammation that causes symptoms.
And for most kids in the new study, it seemed to work. Within two weeks, seven of nine children were showing few to no Crohn's symptoms. Five were still in remission after 12 weeks, with no additional therapy, the researchers reported in a recent issue of the journal Inflammatory Bowel Diseases.
Fecal transplants are not yet approved for treating Crohn's, Suskind said.
They are, however, sometimes used to treat a gastrointestinal infection called C. difficile—with "astounding success," said Dr. Arun Swaminath, who directs the inflammatory bowel disease program at Lenox Hill Hospital in New York City.
So it's "logical" to study the therapy for Crohn's, according to Swaminath, who was not involved in the new research.
He said the new findings are "encouraging," but also limited—partly because there was no comparison group that did not get a fecal transplant.
"We don't know how many patients would have spontaneously gone into remission in this time," Swaminath explained.
Suskind agreed that the findings are only preliminary, and his team is conducting a trial that includes children who do not receive a transplant.
"The preliminary data is promising," Suskind said. "But research into how to manipulate the intestinal microbiome is still young. There are many things we don't understand yet."
It's possible, according to Suskind, that for some Crohn's patients, one fecal transplant could quickly alter the gut microbiome, and from there on, a careful diet could help maintain the benefit.
But much more work is needed to see how "durable" one transplant is, said Dr. Dana Lukin, a gastroenterologist at Montefiore Medical Center in New York City.
Lukin also questioned whether any benefits in children would translate to adults, who likely have a more "diverse" microbiome than kids. Still, he called the early results "promising."
In the other study, researchers in Korea used stem cells to try to repair a serious complication of Crohn's: fistulas. Fistulas are tunnels that connect one loop of intestine to another, or that run beyond the intestines, connecting to the bladder or skin, for example.
The current treatments for fistulas—antibiotics, biologic drugs, "glues" and surgery—rarely banish the problem, Swaminath said.
So these researchers, led by Dr. Chang Sik Yu, tried a new approach: They took stem cells from the patient's own fat tissue, then injected the cells, combined with glue, into the fistula during surgery.
Of 36 patients who were followed for two years, 75 percent were still doing well, with the fistula completely closed, Yu's team reported in the journal Stem Cells Translational Medicine.
Again, the study had no comparison group, Swaminath cautioned.
"But historically," he said, "the best data is about 36 percent remission at one year. So the current study shows a stunning improvement on that."
Lukin agreed that the early results are "impressive," and warrant a larger trial.
Lukin added, though, that even if a big study confirms the stem cell therapy is safe and effective, it requires "specialized techniques" and expertise. So its use in the real world will be limited in the near future.
Explore further: New drug for Crohn's disease shows early promise
More information: The Crohn's & Colitis Foundation of America has more on Crohn's disease.
Copyright © 2015 HealthDay. All rights reserved.
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by Amy Norton, Healthday Reporter
But both trials were small and more research is needed.
(HealthDay)—Two experimental therapies might help manage the inflammatory bowel disorder Crohn's disease, if this early research pans out.
In one study, researchers found that a fecal transplant—stool samples taken from a healthy donor—seemed to send Crohn's symptoms into remission in seven of nine children treated.
In another, a separate research team showed that stem cells can have lasting benefits for a serious Crohn's complication called fistula.
According to the Crohn's & Colitis Foundation, up to 700,000 Americans have Crohn's—a chronic inflammatory disease that causes abdominal cramps, diarrhea, constipation and rectal bleeding. It arises when the immune system mistakenly attacks the lining of the digestive tract.
A number of drugs are available to treat Crohn's, including drugs called biologics, which block certain immune-system proteins.
But fecal transplants take a different approach, explained Dr. David Suskind, a gastroenterologist at Seattle Children's Hospital who led the new study.
Instead of suppressing the immune system, he said, the transplants alter the environment that the immune system is reacting against: the "microbiome," which refers to the trillions of bacteria that dwell in the gut.
Like the name implies, a fecal transplant involves transferring stool from a donor into a Crohn's patient's digestive tract. The idea is to change the bacterial composition of the gut, and hopefully quiet the inflammation that causes symptoms.
And for most kids in the new study, it seemed to work. Within two weeks, seven of nine children were showing few to no Crohn's symptoms. Five were still in remission after 12 weeks, with no additional therapy, the researchers reported in a recent issue of the journal Inflammatory Bowel Diseases.
Fecal transplants are not yet approved for treating Crohn's, Suskind said.
They are, however, sometimes used to treat a gastrointestinal infection called C. difficile—with "astounding success," said Dr. Arun Swaminath, who directs the inflammatory bowel disease program at Lenox Hill Hospital in New York City.
So it's "logical" to study the therapy for Crohn's, according to Swaminath, who was not involved in the new research.
He said the new findings are "encouraging," but also limited—partly because there was no comparison group that did not get a fecal transplant.
"We don't know how many patients would have spontaneously gone into remission in this time," Swaminath explained.
Suskind agreed that the findings are only preliminary, and his team is conducting a trial that includes children who do not receive a transplant.
"The preliminary data is promising," Suskind said. "But research into how to manipulate the intestinal microbiome is still young. There are many things we don't understand yet."
It's possible, according to Suskind, that for some Crohn's patients, one fecal transplant could quickly alter the gut microbiome, and from there on, a careful diet could help maintain the benefit.
But much more work is needed to see how "durable" one transplant is, said Dr. Dana Lukin, a gastroenterologist at Montefiore Medical Center in New York City.
Lukin also questioned whether any benefits in children would translate to adults, who likely have a more "diverse" microbiome than kids. Still, he called the early results "promising."
In the other study, researchers in Korea used stem cells to try to repair a serious complication of Crohn's: fistulas. Fistulas are tunnels that connect one loop of intestine to another, or that run beyond the intestines, connecting to the bladder or skin, for example.
The current treatments for fistulas—antibiotics, biologic drugs, "glues" and surgery—rarely banish the problem, Swaminath said.
So these researchers, led by Dr. Chang Sik Yu, tried a new approach: They took stem cells from the patient's own fat tissue, then injected the cells, combined with glue, into the fistula during surgery.
Of 36 patients who were followed for two years, 75 percent were still doing well, with the fistula completely closed, Yu's team reported in the journal Stem Cells Translational Medicine.
Again, the study had no comparison group, Swaminath cautioned.
"But historically," he said, "the best data is about 36 percent remission at one year. So the current study shows a stunning improvement on that."
Lukin agreed that the early results are "impressive," and warrant a larger trial.
Lukin added, though, that even if a big study confirms the stem cell therapy is safe and effective, it requires "specialized techniques" and expertise. So its use in the real world will be limited in the near future.
Explore further: New drug for Crohn's disease shows early promise
More information: The Crohn's & Colitis Foundation of America has more on Crohn's disease.
Copyright © 2015 HealthDay. All rights reserved.
Medical Xpress on facebook
Related Stories
New drug for Crohn's disease shows early promise
(HealthDay)—An experimental drug may quickly quash symptoms of the digestive disorder Crohn's disease—at least for the short term, an early clinical trial finds.
Slowed growth could signal Crohn's disease in kids
(HealthDay)—A lag in growth could be a sign that a child might suffer from undiagnosed inflammatory bowel disease (IBD), especially Crohn's disease, one pediatric doctor says.
Fecal transplants successful for treating C. difficile infection
Distasteful though it sounds, the transplantation of fecal matter is more successful for treating Clostridium difficile infections than previously thought.
Researcher tests fecal microbial transplant to treat recurring C. difficile infection and inflammatory bowel disease
Dina Kao has never been as satisfied with her work as she is today. A practising gastroenterologist at the University of Alberta Hospital, she says much of that satisfaction comes from seeing patients benefit ...
Newly diagnosed Crohn's disease patients show imbalance in intestinal microbial population
A multi-institutional study led by investigators from Massachusetts General Hospital (MGH) and the Broad Institute has identified how the intestinal microbial population of newly diagnosed Crohn's disease patients differs ...
Recommended for you
Can humans get norovirus from their dogs?
Human norovirus may infect our canine companions, according to research published online April 1 in the Journal of Clinical Microbiology, a publication of the American Society for Microbiology. That raises ...
Tekmira will resume safety study of Ebola drug within weeks
Canadian drugmaker Tekmira Pharmaceuticals said Friday it will restart a study of an experimental Ebola treatment in the coming weeks.
Q&A: What is listeria?
Large food recalls have forced consumers to throw away hummus and ice cream that may be contaminated with the same potentially deadly bacteria—listeria.
Bird flu confirmed at four more Minnesota turkey farms
A deadly bird flu strain was confirmed Friday at four more turkey farms in Minnesota, raising the number of farms affected in the country's top turkey-producing state to 13 and the toll at farms across the Midwest to over ...
New guidance on contact precautions for hospital visitors
Leading infectious diseases experts have released new guidance for healthcare facilities looking to establish precautions for visitors of patients with infectious diseases. The guidance looks to reduce the potential for healthcare ...
UN: Ebola still global emergency despite big drop in cases
The World Health Organization says the year-long Ebola outbreak in West Africa still qualifies as an international emergency even though the number of cases has plummeted.
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