Human IL-23 is essential for IFN-γ–dependent immunity to mycobacteria

[asadmom]

IL-23 supports innate IFN-γ production by innate-like T cells

https://www.science.org/doi/10.1126/sciimmunol.abq5204

 

[Scipio]

Interesting. If it is correct, this paper tells against the MAP theory of Crohn's genesis, since if suppressing IL-23 leads to reduced IF-gamma mediated Mycobacteria immunity, then under MAP theory drugs such as Stelara and Skyrizi should cause MAP to flourish, making Crohn's worse, not better.

As clearly indicated by a growing number of patients and parents on this forum, Stelara often reduces Crohn's inflammation - frequently by a lot.

 

[Pangolin]

Another possibility is that the body is responding to mycobacteria but that response is excessive or unnecessary. Perhaps people are fine without that immune response and the mycobacteria doesn't spread, but maybe eliminating the mycobacteria (which may not be possible) could also prevent the immune response.

 

[Kannassee]

Maybe Crohn’s is caused by different pathogens in different people?…..for some people it may be Mycobacteria and for others something else.?
That may be why for some people Stelara works and for others it doesn’t work….

 

[Kannassee]

Since I started Stelara my FCP has been going up.

Maybe its suppressing IL-23 and now I have reduced IF-gamma mediated Mycobacteria immunity?, maybe MAP is then flourishing, making Crohn's worse, not better for me.

Lots of 'maybe"!!!

Maybe other people's Crohns is not related to Mycobacteria and Crohns gets better with Stelara.

Well all of this of course is just wishful thinking.!!!
When I was on Infliximab FCP values went straight down.

 

[Scipio]

FCP going up is a worrying development. How are your symptoms?

 

[asadmom]

I know this young boy whose calpro actually went up significantly after 10 weeks of EEN. The parents were of course shocked and frustrated. They were hoping that EEN would save the day since he also failed a few drugs.

So @Kannassee you are right, of course, that there are so many different variations under the umbrella term "Crohn's". The way to tackle is to try the drug or diet and figure our way backwards then we can have groups called "Stelara-friendly", "Humira-no-go"... I am being sarcastic.

 

[Kannassee]

FCP going up is a worrying development. How are your symptoms?

Well last week symptoms were.....everyday after I eat after some hours everything goes out, and I began to have spasm and colic pain......the next day Imodium doesnt help very much.

I reduced the amount of food that I am eating and now it is much better. I think that I was eating too much probably. Anyway my GI wants to see me next week, lets see what he thinks.

I feel like that I get better symptoms wise after the Stelara injection but after 4 to 5 weeks my symptoms kind of reappear.

Maybe this is not very objective.!!!

 

[Pilgrim]

In our experience Stelara took 12-16 months to be therapeutic and that was at 4 week dosing.