Drug study brings hope for bowel disease sufferers

May 22 2013

Dr Simon Keely

Dr Simon Keely has shown the potential of a new therapy for Inflammatory Bowel Disease.

University of Newcastle researchers have shown the potential of a new drug to accelerate the healing process for debilitating inflammatory bowel diseases (IBDs) such as Crohn’s disease and ulcerative colitis.

In collaboration with the University of Colorado (USA) and biopharmaceutical company Aerpio Therapeutics, they found that a type of drug known as a prolyl hydroxylase inhibitor (PHDi) tricks gut tissue into an early triggering of the intestine’s healing mechanisms.

The findings are published today in the international journal Mucosal Immunology.

“One of the key ways that this drug works is in restoring the lining of the gut, the wall that separates the contents of your intestines from your blood supply,” lead researcher Dr Simon Keely said.

“With inflammatory bowel disease the barrier that stops bacteria and toxins getting through is broken; this drug effectively closes the barrier while also making the gut lining more resistant to attack.
“We found in our modelling that it activates proteins, known as integrins, which allow the damaged gut lining to reseal and eventually close. Our goal is to fast-forward the healing mechanism so we can prevent IBD flares, give people a better lifestyle and reduce the need for surgery.”

IBD patients commonly suffer from chronic abdominal pain and may need to use the toilet as often as 25 times a day. These symptoms can lead to anxiety and depression, while also causing a dependency on medications required to treat the disease.

The disease affects approximately 75,000 people nationally, although clinicians suspect the incident rate is higher because many Australians are shy about discussing their symptoms. National support group Crohn’s and Colitis Australia is running IBD Awareness Month throughout May.

“As well as the major impact on patient quality of life, IBD has a disproportional impact on health care costs because endoscopies and medication are relatively expensive,” Dr Keely said. “The 75,000 known patients account for around $2.7 billion in annual health care costs – that’s $36,000 per person, which includes work absenteeism, reduced productivity and actual costs.

“The diseases are rarely fatal once treated but have an extremely high impact on health and wellbeing because there is currently no cure. Current therapies are designed to limit periods of intestinal inflammation but the existing drugs aren’t good enough and about 75% of patients will still undergo surgery to remove sections of the intestine that have been irreparably scarred by recurring cycles of inflammation.”

With the gastrointestinal tract being the largest organ in the body – equivalent to a basketball court in surface area – Dr Keely’s research team is interested in further understanding how tissues adapt to inflammation, particularly why some people heal and others do not.

They have begun recruiting for a clinical study at John Hunter Hospital to monitor disease stages and the natural expression of the healing protein.
“Basically we want to create a map of the healing process to see when the level of integrin protein is at its highest,” Dr Keely said. “We are gradually figuring out how PHDi drugs work and these therapies may not be too far from clinical trials.”

 IBD patients who would like to participate in the John Hunter Hospital trial can phone Mel Young on (02) 4921 4853.

Background:

  • Inflammatory Bowel Disease is the umbrella term for a group of chronic digestive disorders in the gastrointestinal tract – most notably Crohn’s disease which is a deep tissue disease that extends from the gut wall lining, and Colitis which involves ulceration.
  • Australia has one of the highest incident rates of IBD in the world, and the amount of new cases is continually rising. The cause is unknown.
  • Most sufferers are diagnosed in young adulthood, around the age of 25, and it’s a life-long disease. • Gut disorders can lead to downstream complications with rheumatoid arthritis, dermatological inflammation such as rashes, eye diseases, and potentially lung conditions such as emphysema.


* Dr Simon Keely is a member of HMRI’s Virus, Infections/immunity, Vaccines and Asthma (VIVA) Program. HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.