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Ulcerative colitis research update

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Ulcerative colitis refers to chronic inflammation of the lining of the large intestine. It leads to the formation of small sores called ulcers that cause digestive symptoms and sometimes complications such as malnutrition.

Recent studies have helped scientists develop a better understanding of ulcerative colitis, including its potential causes and treatments.

Ongoing research may help them develop new strategies for preventing, diagnosing, and managing the condition.

Read on to learn about the latest research findings.

The gastrointestinal tract contains more than 100 trillion microbial cells. Many gut microbes in this gut microbiome are “friendly” bacteria that help keep the body healthy. They influence metabolism, nutrition, immune function, and more.

Scientists have linked microbial disruption in the gut to several chronic conditions, including ulcerative colitis and other types of inflammatory bowel disease (IBD).

The authors of one 2020 study from the Stanford University School of Medicine looked at the effect of colectomy with ileal pouch-anal anastomosis on gut microbes. Some people with ulcerative colitis undergo this operation to remove damaged bowel.

They found that people with ulcerative colitis who developed pouchitis after surgery had low levels of Ruminococcaceae bacteria in their digestive systems.

Pouchitis refers to ongoing intestinal inflammation after IBD surgery. According to the study authors, about 50% of people who undergo this procedure experience it.

People with pouchitis also had low levels of secondary bile acids (SBAs). These anti-inflammatory substances are made by Ruminococcaceae bacteria.

The authors of the Stanford study hypothesized that low levels of Ruminococcaceae bacteria and SBAs in people with IBD may lead to increased inflammation that drives both IBD and pouchitis.

Past research has also found that people with IBD tend to have lower levels of SBAs than people without the condition.

The Stanford research team is now conducting a clinical trial to learn whether or not taking SBA supplements can reduce inflammation in people with ulcerative colitis after surgery.

Scientists have not identified any single food or specific diet that causes, prevents, or treats ulcerative colitis.

However, some people with ulcerative colitis find that their symptoms improve when they eat or avoid certain foods. Different people may benefit from different diets.

Scientists have studied the effects of several diets on IBD, including:

  • the Mediterranean diet, which is low in red meat and high in whole grains, vegetables, fruits, nuts, and monounsaturated fats
  • the specific carbohydrate diet, which cuts out all grains
  • the low FODMAP diet, which limits certain types of carbs
  • a gluten-free diet, which eliminates wheat and other glutenous grains

The authors of one 2021 review of studies found some evidence that linked the Mediterranean diet to higher quality of life and lower disease activity in people with IBD. However, research findings on this diet were mixed.

According to the review, the specific carbohydrate diet also shows promise for reducing symptoms and disease activity in IBD. Most of the research into this diet has focused on children.

The review found that a low FODMAP diet does not appear to reduce disease activity in IBD. However, some evidence suggests that it might ease digestive systems in some people.

The review also found that some people with IBD report improved symptoms when they avoid gluten. However, one cited study found no link between gluten-free diets and disease activity in IBD.

The researchers explained that some foods help support a diverse and healthy gut microbiome. They speculated that certain diets may help control inflammation in the gut to potentially prevent or help treat IBD.

The Mediterranean diet is filled with antioxidant-rich foods that research suggests may help boost the gut microbiome and lower inflammation to reduce the risk of some chronic conditions.

The available research into diet in IBD is limited. More research is necessary to learn how various eating plans affect people with ulcerative colitis.

In 2018, the Food and Drug Administration (FDA) approved tofacitinib (Xeljanz) to treat moderate-to-severe ulcerative colitis.

Xeljanz is a Janus kinase (JAK) inhibitor that blocks certain proteins involved in inflammation. It is 34.3% to 40.6% effective at bringing ulcerative colitis into remission after 52 weeks of treatment, according to one 2021 review.

Scientists are also studying the treatment of ulcerative colitis with:

  • other JAK inhibitors
  • interleukin-23 inhibitors, which are a type of biologic
  • sphingosine 1 phosphate receptor modulators
  • apremilast (Otezla)
  • stem cell transplant
  • fecal microbiota transplant

Some of these treatments may be effective for people with ulcerative colitis who do not respond well to current treatment options.

Researchers are continuing to study these treatments to learn how safe and effective they are for treating ulcerative colitis.

Healthcare professionals can better understand how active a person’s ulcerative colitis is by monitoring inflammation in their body. This information can help guide whether or not it is necessary to adjust their treatment plan.

To continuously monitor inflammation, scientists are developing and testing novel biosensors. These sensors use enzymes, antibodies, or other biological molecules to detect certain chemicals in the body.

For example, researchers from the University of Texas at Dallas have designed a wearable wrist device that monitors sweat for biomarkers of inflammation.

Scientists are also designing and testing ingestible biosensors. These include tiny detectors and transmitters that people swallow in capsules. Some ingestible biosensors detect gases or other chemicals that provide information about the health of the person’s digestive system.

Biosensors may eventually help people with ulcerative colitis get treatment earlier when inflammation increases or complications develop.

Scientists are also making progress in understanding the genetics of ulcerative colitis.

Most experts agree that the condition results from complex interactions between genetics, environmental factors, microbes, and immune responses.

Scientists have linked 260 genetic variants to IBD, most of which affect the risk of both ulcerative colitis and Crohn’s disease.

Learning about the role that specific genes play may help scientists identify new treatment targets for ulcerative colitis. It may also help experts target the most beneficial available treatments to people based on their genetic makeup.

Researchers continue to study the underlying causes of ulcerative colitis, as well as novel strategies for diagnosing, monitoring, and treating the condition.

Ongoing studies may help experts develop new medications and tools for managing ulcerative colitis. It may also help them learn which people are most likely to benefit from specific treatments.

People with ulcerative colitis can speak with a doctor to learn more about the new and experimental treatments for the condition.

https://www.medicalnewstoday.com/articles/research-update-ulcerative-colitis

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