New Research on Drug Resistance in Crohn's Disease

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JUPITER, Fla.—Two-thirds to three-quarters of the estimated 700,000 Americans living with Crohn’s disease, an autoimmune condition that can disrupt the entire gastrointestinal tract, will require surgery at some point during their life. Patients and physicians often turn to this surgical intervention after a patient develops resistance to current treatments, such as steroids.

Now scientists from the Florida campus of The Scripps Research Institute (TSRI) have identified a normally small subset of immune cells that may play a major role in the development of Crohn’s disease generally and in disease-associated steroid resistance specifically.

The study, published this week in an advance, online edition of the Journal of Experimental Medicine, focused on Th17 cells, part of a family of white blood cells that have been implicated in numerous autoimmune diseases, including Crohn’s disease.

In the new study, the researchers found that a subset of TH17 cells in humans expresses the multidrug transporter MDR1 and that these cells are linked to inflammation in Crohn’s patients. MDR1—a protein famous for promoting drug-resistance in tumors—may also act as a survival and steroid resistance factor in T cells, particularly in harsh environments such as the inflamed gut mucosa of Crohn’s disease patients.

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