The immunomodulatory role of Vitamin D in Inflammatory Bowel Disease (IBD), St Mark’s

 

Background & rationale for this project

Vitamin D is important for healthy bones.  In addition, it was suggested that it could help to regulate the inflammatory process and thus could be used in the treatment of IBD. Vitamin D is currently a very topical subject with emerging anti-cancer and anti-inflammation properties under investigation. 

 

Research Aims

- To investigate the effect of vitamin D on immune cells in the laboratory

- To demonstrate the effectiveness of vitamin D as a treatment for inflammation in a clinical trial involving IBD patients

 

Results

This project found that Vitamin D can help to prevent the immune system from behaving in the way it does to cause inflammation in Crohn's patients.  This is a really pivotal study showing the potential for Vitamin D to help Crohn's sufferers.  So far these tests have been done in the lab and more tests need to be done in humans on the practicalities of how the Vitamin D would be used. 

An article about this was published in the 'Nature' journal (a top medical journal which includes new research findings). 

 

Improving Wound Healing in Patients with Crohn's Disease, St Mark’s 

 

Background and rationale for this research

Wounds following surgery in Crohn’s disease do not appear to heal by the same processes as wounds in healthy individuals.  Around 80-90% of patients with Crohn’s disease will need to undergo surgery at least once in their lifetime.  Following surgery a significant number of patients are physically and mentally debilitated as a result of poor wound healing.  These patients often experience a poor quality of life with life-limiting pain, recurrent wound infections and persistent unpleasant drainage of pus. 

 

Research Aims

To understand the difference between the way wounds heal between those with Crohn’s and those without Crohn’s. 

To use the greater understanding of how wounds heal in Crohn’s to find a new, novel treatment for Crohn’s disease wounds to improve healing. 

 

Interim Results

The key findings from this project are that the dendritic cells (those that direct antibodies to areas of wounds to enable healing and fight infection) are sending the immune system away from the wound in Crohn's patients!  Also, the T-cells (soldiers of the immune system) are greatly reduced in Crohn's patients. 

 

These findings are very exciting and lay the groundwork for understanding how to develop novel ways of programming dendritic cells to go in the right direction or finding ways of increasing the wound homing marker in Crohn's disease.  The next phase of this research includes further research around this.   

 

Microbiology in Crohn's Anal Fistulae, St Mark’s

 

This was a project consisting of a microbiological analysis of anal fistulae to provide a greater understanding of fistulae and how to treat them. 

 

There were a series of novel findings in the microbiological make up.  Top line explanation (!) there was some relevant bacteria missing, a lack of homing markers which leads to a chaotic immune response, and more T-cells in Crohn's rectums than non-Crohn's.  None of this information was known previously so it is very exciting that the research revealed these differences. 

 

All this leads to a greater understanding of fistula tract inflammation but also leads to more questions and the need for more research as to how these differences come about and what can be done in Crohn's patients to make the rectum react the same way as a non-Crohn's person.