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Interesting research/articles/videos etc.

Hello everyone,

I was recently diagnosed with Crohn's disease affecting my terminal ileum (for now). Fortunately, I was very asymptomatic because I experienced a few days of abdominal discomfort and thereafter went on with my life without severe symptoms. I could eat anything and do anything. However, some of my blood markers were a little contradictory and my GP pressed for an endoscopy. Better safe than sorry, I went on and they found smaller than 1mm aphthous spots in my TI. The mental blow was harder than the physical one I must admit. Started with Budesonide and doing the same as before haha. Before taking the first dose, my blood was tested again and my CRP was 0.5 therefore I am very interest in how they will 'measure' the effectiveness.

Coming to the point of this thread. I am very optimistic and interested in recent research and found already nice stuff on this forum regarding medical breakthroughs and research. I am planning to post some things I find myself on the internet here and hopefully some nice discussion about it will unfold. Besides, I hope other people will contribute with interesting stuff they come across on the internet.

Yours sincerely,

K
 
To start,

I just saw this video with some nice information:


Very short summary:

It outlines some current treatments and new treatments in the near and far future. The speaker nicely compares several drugs for their efficiency etc.
 
Also, I did some further digging on the video of Mark Sundrud (posted in another topic, so wont do that again). Here is an overview of some publications:

https://sundrudlab.com/papers/

Especially the most recent publication is interesting in my perspective:

Bile acids are lipid-emulsifying metabolites synthesized in hepatocytes and maintained in vivo through enterohepatic circulation between the liver and small intestine1. As detergents, bile acids can cause toxicity and inflammation in enterohepatic tissues2. Nuclear receptors maintain bile acid homeostasis in hepatocytes and enterocytes3, but it is unclear how mucosal immune cells tolerate high concentrations of bile acids in the small intestine lamina propria (siLP). CD4+ T effector (Teff) cells upregulate expression of the xenobiotic transporter MDR1 (encoded by Abcb1a) in the siLP to prevent bile acid toxicity and suppress Crohn’s disease-like small bowel inflammation4. Here we identify the nuclear xenobiotic receptor CAR (encoded by Nr1i3) as a regulator of MDR1 expression in T cells that can safeguard against bile acid toxicity and inflammation in the mouse small intestine. Activation of CAR induced large-scale transcriptional reprogramming in Teff cells that infiltrated the siLP, but not the colon. CAR induced the expression of not only detoxifying enzymes and transporters in siLP Teff cells, as in hepatocytes, but also the key anti-inflammatory cytokine IL-10. Accordingly, CAR deficiency in T cells exacerbated bile acid-driven ileitis in T cell-reconstituted Rag1−/− or Rag2−/− mice, whereas pharmacological activation of CAR suppressed it. These data suggest that CAR acts locally in T cells that infiltrate the small intestine to detoxify bile acids and resolve inflammation. Activation of this program offers an unexpected strategy to treat small bowel Crohn’s disease and defines lymphocyte sub-specialization in the small intestine.

I hope that a company does further invest in this possible pathway. It may not be THE holy grail but as Sundrud explains in the video, it is a possible cause in a portion of patients. Elaborating on that, after reading quite some publications I think that a lot is trashed in the Crohn's disease corner while it is possibly not one but several different diseases and just suppress the immune system. But I think things are changing as some people mentioned earlier on this forum.
 
Lastly (for tonight),

I saw that Takeda mentions the Sibofimloc/ Fimh blocker in their pipeline on the website and it is planned for FY2025 for now. Anyway, very interested in the read-out of the phase 2 trial in early 2023!

Have nice evening.
 
I really didnt like that S.Hanauer latest video, a future of combo biologic immune supression. Don't like the sound of that.

In my eyes he is positive about taking treatment completely further in the wrong direction. We want safer more targeted drugs, not double immune supression that is very non targeted.

But welcome Kilicad, great to have another person here interested in the research side of things.
 
Thank you westernbuddy! I agree that the immune suppression approach with biologicals is something we hopefully won't need anymore in the coming 10 years or so. But I think there are some promising drugs currently being researched such as Sibofimloc.
Anyway I found this slightly outdated overview on a website with new treatments in advanced stages:

https://www.frontiersin.org/files/A...-651415-HTML/image_m/fphar-12-651415-t001.jpg

And also this market analyses:

https://www.emjreviews.com/gastroen...disease-cells-surgery-and-novel-therapeutics/

I am very interested in the new kids on the block, the JAK inhibitors. There are some contradictory signals but hopefully they will become a new treatment approach for all those people who fail(ed) other treatments. Long term remission rates etc is something I am very interested in. Worrying is the risico profile of some with reactivation of Herpes Zoster and the lack of endoscopic remission in filgotinib.

In that light, the Risankizumab trial show some very promising results with endoscopic remission. As an Il-23 inhibitor, thus similar to Ustekunimab, it is exciting to see the endoscopic remission rates of 39% and 29% in deep remission for moderate to severe crohn's disease patients!

More info about this: https://news.abbvie.com/news/press-...sponse-and-clinical-remission-at-one-year.htm

I was also looking for videos of the lates (A)IBD conference in the U.S. but could not find them right away, if someone does have links or material please let me know, thank you in advance!

Have a nice day.
 
Also, people on Twitter and interested in news or views on Crohn's disease treatment, I would recommend to follow the people behind 'Propel a Cure for Crohn's disease' This is their website:

https://www.propelacure.org/

They are also the ones with the videos in the other posts with Mark Sundrud and Brian Coombes. Anyway some of the founders are on Twitter and show some interesting insights / threads about treatments etc.

Also the twitter of the IBD conference with some interesting pics, therefore if someone has the videos, I am very interested!

https://twitter.com/IBDConference
 
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Today I discovered this interesting research (link below). I did read the previous research of them (I think from 2009) and it gives valuable insight in the (changing) clinical course of Crohn's disease in a population based study in Norway. This new study published only the collected data but I suspect that interesting insights will follow.

The 2021 research:
https://www.tandfonline.com/doi/full/10.1080/00365521.2021.1922746

Anyway, it does not give many insights right now but interesting to follow!

The 2009 research with insights is also interesting but notice that the biological era just started and this a big factor is in disease course:
https://www.cghjournal.org/article/S1542-3565(07)00888-9/fulltext

Conclusion of the 2009 study:
"The prognosis for CD seems better than previously reported. The probability of surgery was low, and fewer than expected developed complicated disease behavior. Nevertheless, the cumulative relapse rate of 90% and the finding of prognostic risk factors for subsequent surgery might call for attention to early effective medical treatment strategies."

Very exciting to see a new analysis with the recent data!
 
Sibofimloc
Sibofimloc, which is currently the only drug candidate targeting the underlying cause of the disease, is in a Phase 2 trial in post-operative Crohn's disease and a data readout is expected in H1 2023.
 
Hello Crohn2357 and artheta,

I did read the SSI website (Q biologics) but I think they are rather quite for some time, citing that further research depends on funding. Hopefully more on that in future.

Regarding the MAP vaccine and rhb-104, I thought the trials of rhb-104 were a bit disappointing. I am aware that it has similar remission rates as some biologicals but for a drug that was claimed to be the 'solution' for Crohn's disease, at least in theory by some, was not what I expected. Anyway, it could still be possible that MAP is the cause for some patients, and this may be the cure but I don't think it will be the solution for every patient. Still hoping that the vaccine trials will prove me wrong haha.

Stem cell therapy was something with exciting developments especially for fistulas.
 
https://www.hindawi.com/journals/ijr/2013/610393/

Anyone some opinion on this research? It is quite old but and it is not often cited. Nevertheless, the publication mentions trials with Rifaximin to treat Crohn's disease and the mentioned remission rates are pretty impressive. I've found a current phase 2 trial with Rifaximin, looking forward to the results.
 
https://www.hindawi.com/journals/ijr/2013/610393/

Anyone some opinion on this research? It is quite old but and it is not often cited. Nevertheless, the publication mentions trials with Rifaximin to treat Crohn's disease and the mentioned remission rates are pretty impressive. I've found a current phase 2 trial with Rifaximin, looking forward to the results.
I did a course of rifaximin without any lasting effect, though of course, only one data point isn't significant by itself
 
Location
San Diego
https://www.hindawi.com/journals/ijr/2013/610393/

Anyone some opinion on this research? It is quite old but and it is not often cited. Nevertheless, the publication mentions trials with Rifaximin to treat Crohn's disease and the mentioned remission rates are pretty impressive. I've found a current phase 2 trial with Rifaximin, looking forward to the results.
It's not often cited for a good reason. I don't know anything about that particular paper, but I do know that the publisher, Hindawi, has a poor reputation and has been accused of freely publishing low-quality results.

Over the past 15 years or so, the once conservative and respectable business of scientific publishing has been invaded and polluted by dozens, even hundreds, of so-called "predatory journals" that freely publish all kinds of nonsense that range from the merely low-quality to the outright fraudulent. The hallmarks of a predatory journal is that they are usually open access (although there are a few legit open access journals), they are frequently published out of Asia or the Middle East, and their so-called "peer reviewers" are people unknown in the scientific discipline and are sometimes merely friends and family of the predatory publisher.

And according to some observers Hindawi fits the description. They may not be outright fraudulent, but I tend to look at the stuff Hindawi publishes with a dubious attitude.

Experienced scientists usually don't have much trouble separating the wheat from the chaff among scientific publishers, but sometimes young scientists just starting out make the mistake of publishing their work in one of the questionable journals. And the unsuspecting general public is usually completely fooled by these journals.

If you want to read more about this phenomenon, google "predatory journals."
 
It's not often cited for a good reason. I don't know anything about that particular paper, but I do know that the publisher, Hindawi, has a poor reputation and has been accused of freely publishing low-quality results.

Over the past 15 years or so, the once conservative and respectable business of scientific publishing has been invaded and polluted by dozens, even hundreds, of so-called "predatory journals" that freely publish all kinds of nonsense that range from the merely low-quality to the outright fraudulent. The hallmarks of a predatory journal is that they are usually open access (although there are a few legit open access journals), they are frequently published out of Asia or the Middle East, and their so-called "peer reviewers" are people unknown in the scientific discipline and are sometimes merely friends and family of the predatory publisher.

And according to some observers Hindawi fits the description. They may not be outright fraudulent, but I tend to look at the stuff Hindawi publishes with a dubious attitude.

Experienced scientists usually don't have much trouble separating the wheat from the chaff among scientific publishers, but sometimes young scientists just starting out make the mistake of publishing their work in one of the questionable journals. And the unsuspecting general public is usually completely fooled by these journals.

If you want to read more about this phenomenon, google "predatory journals."
here is an article you might find interesting, its from 2012.
link
 
It's not often cited for a good reason. I don't know anything about that particular paper, but I do know that the publisher, Hindawi, has a poor reputation and has been accused of freely publishing low-quality results.

Over the past 15 years or so, the once conservative and respectable business of scientific publishing has been invaded and polluted by dozens, even hundreds, of so-called "predatory journals" that freely publish all kinds of nonsense that range from the merely low-quality to the outright fraudulent. The hallmarks of a predatory journal is that they are usually open access (although there are a few legit open access journals), they are frequently published out of Asia or the Middle East, and their so-called "peer reviewers" are people unknown in the scientific discipline and are sometimes merely friends and family of the predatory publisher.

And according to some observers Hindawi fits the description. They may not be outright fraudulent, but I tend to look at the stuff Hindawi publishes with a dubious attitude.

Experienced scientists usually don't have much trouble separating the wheat from the chaff among scientific publishers, but sometimes young scientists just starting out make the mistake of publishing their work in one of the questionable journals. And the unsuspecting general public is usually completely fooled by these journals.

If you want to read more about this phenomenon, google "predatory journals."
Hello Scipio,

I already thought it to be a little shady when coming across other research from this specific journal. Thank you for the explanation! I will keep an eye on this in the future. Last thing I want is to spread disinformation or something similar.
 
Interesting to read! hopefully this will lead to some very specific and targeted drugs. Still far away but somewhere I am hopeful that one day Crohn's disease will be something that isn't life altering anymore and it can be effectively treated.

Have a nice evening.
 
Hello everyone,

Here an article about EEN in adults and how it works (mechanism).

https://www.dovepress.com/exclusive...iew-of-cli-peer-reviewed-fulltext-article-CEG
From the article:
The per-protocol subgroup analysis showed a difference in remission rates for both adults (RR 0.82, 95% CI 0.70–0.95) and children (RR 1.43, 95% CI 1.03–1.97).
This seems to be saying that an adult being on EEN is even less likely to achieve remission than an adult who isn't on it. I can't really explain that, other than that I may be misinterpreting it.

But for children, EEN does appear to work. Maybe this has something to do with the longer disease duration in adults, and progression to stricturing or fistulizing Crohn's.
 
I have read in the past it's not as effective the second time.

I have experienced that, 1st time doing ENN as an adult, felt like my crohns had been hit with an Army, deep remission very fast.

2nd time ten years later, no where near as effective, and I don't know why exactly, just putting out the inflamation it was not as effective.
 
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