US_Gastro_NR.qxp 9/10/07 9:21 am Page 14
News Round-up
The US Gastroenterology Arena—In Brief
A Round-up of Trends, Statistics, and Clinical Research
Gene Identified For Crohn’s Escherichia coli bacteria and the onset of considers an individual’s mucosa-associated flora
Disease in Children Crohn’s disease. in addition to disease phenotype and genotype
Pediatric researchers from the Children’s Hospital may improve outcome.” ■
of Philadelphia and the University of Pennsylvania The researchers at Cornell have shown that
have found a gene variant responsible for a E. coli bacteria—which contain similar genes to Non-invasive Ablation Now
heightened risk of Crohn’s disease in children. uropathogenical and avian pathogenical E. coli Available for Barrett’s Esophagus
and enteropathogenical bacteria such as Non-invasive ablation of Barrett’s esophagus
The genomes of of 143 children with Crohn’s salmonella, cholera, and bubonic plague—are is now offered by interventional gastro-
disease were compared with the genomes of associated with intestinal inflammation in enterologists at Rush University. The procedure
282 matched control subjects. A variant form of patients with Crohn’s disease. The link between uses a sizing balloon, an ablative energy
the gene ATG16L1 was found in 64% of gut bacteria and Crohn’s disease was previously generator, and an ablation catheter. The balloon
the children with Crohn’s disease compared suspected, but the specific bacterial catheter is inserted into the esophagus during
with 52% in healthy children. Those with the characteristics causing the inflammatory endoscopy. Once the balloon is inflated,
variant were at 64% greater risk of having response were not understood. The study radiofrequency energy is delivered to remove the
Crohn’s disease. An association between the looked for possible causes of the disease in diseased tissue. According to Sri Komanduri, MD,
ATG16L1 gene variant and disease symptoms patients with Crohn’s restricted to the ileum a physician with the interventional endoscopy
was also found in a separate test analyzing and the colon compared with healthy program at Rush, prior to this procedure “the
Crohn’s patients and their parents. “Because individuals. A higher level of E. coli bacteria was only treatment available for Barrett’s esophagus
Crohn’s disease is complex, with multiple genes found in the more inflamed areas of the small involved frequent surveillance endoscopies to
interacting with each other and with intestines, rather than mavium subspecies look for any progression to dysplasia (pre-
environmental factors, it’s important to sort out paratuberculosis (MAP), the bacterium related cancerous tissue) or cancer.”
specific genes and to replicate previous to tubercle bacillus that is more commonly
findings,” said the study’s first author, Robert N associated with Crohn’s disease. During the procedure, patients are consciously
Baldassano, MD. sedated and experience only minor discomfort.
“Our findings raise the possibility that a novel Following the procedure, patients resume acid-
The ATG16L1 gene has an important function in group of E. coli contains opportunistic pathogens suppression therapy. Multicenter clinical trials in
the autophagosome pathway that processes that may be causally related to chronic intestinal the US have shown that the HALO 360 System
intracellular bacteria. According to Baldassano, a inflammation in susceptible individuals,” said eliminates Barrett’s esophageal tissue in the
variant in the gene may compromise the cell’s Kenneth Simpson MD, Professor of Small Animal majority of cases. Barrett’s affects an estimated
ability to break down cellular waste products, Medicine at the College of Veterinary Medicine. 3.3 million adults in the US. If left untreated, it
including bacteria. An accumulation of “They suggest that an integrated approach that can progress to esophageal cancer. ■
unprocessed waste products within the cell may
then provoke the inflammation symptomatic of
Upper Gastrointestinal Disorders Development Pipeline, by Selected Drug Class
Crohn’s disease. Baldassano comments, “If an
excess of bacteria is the problem, we may find
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antibiotics effective in treating this type of
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Crohn’s disease. Other approaches may be to use
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immune-boosting drugs to blunt the
inflammation, or determining whether particular
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foods interact with genetic susceptibilities to
Number of drugs
4
affect disease symptoms. Understanding gene
2
influences gives us a more targeted way to look
at disease physiology, and also may suggest
0
Phase I Phase II Phase III Registration
targets for treatment.” ■
Escherichia coli Bacteria Associated
Proton pump inhibitors CCK receptor antagonist 5HT4 receptor agonist
with Crohn’s Disease MGluR5 antagonist 5HT1 receptor antagonist GABA-B agonist
Scientists from Cornell University have
established a link between a novel group of Source: Touch Briefings.
14 US GASTROENTEROLOGY REVIEW 2007
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