New Approach May Prevent Strictures in Crohn's Disease

A novel treatment that utilizes a natural protein may decrease the number of surgeries needed by Crohn’s disease patients, according to the results of a recent study. Published in the inaugural issue of Cellular and Molecular Gastroenterology and Hepatology, the study examined a treatment for fibrosing strictures that obstruct the intestines and cause a major complication of Crohn’s disease.

“We found that the antimicrobial defense protein cathelicidin can prevent such intestinal fibrosis in preclinical disease models,” senior author Hon Wai Koon, PhD, said in a press release. “These findings may lead to novel therapeutic approaches that prevent recurrent strictures in Crohn’s disease patients.”

The study evaluated whether the use of cathelicidin, which is part of a family of antimicrobial proteins produced by numerous cell types, can prevent collagen synthesis and fibrosis in intestinal disease to reduce strictures that frequently cause bowel obstructions and multiple surgical resections. As a result of these surgeries, patients are left with so little bowel that nutrients have to be provided intravenously because they are not adequately absorbed from food.

In a mouse model of Crohn’s disease that induced chronic colitis and fibrosis over 7 weeks, instilling cathelicidin through the colon over the final 3 weeks limited weight loss and microscopic disease features, in addition to reducing the production of tumor necrosis factor-α. The therapy also reduced microscopic evidence of fibrosis and production of mRNA for synthesis of collagen. The expression of transforming growth factor-α, which carries anti-inflammatory and pro-regenerative properties, was not affected by the treatment.