Back to infammation

[Guest guest]

Hello Dr ****, I thought you would find it interesting ....I looked up the drug after reading an account in Saturday's press about a child who on taking the drug experienced an improvement of mega proportions with her arthritis ..I'm always on the lookout for such stories , I look to see if infection & inflammation are involved..Well so it is here. The drug is effective against chrohn's , Ms & Ankylosing spondylitis + others.. They are all of course infection based diseases [see below ] It is claimed that REMICADE works by blocking immune system's overproduction of a protein called TNF-alpha, a primary cause of inflammation. If you read s paper you will find that overproduction of TNF-alfa is part of the process of the Angiotensin 11 inflammatory influence So what we are looking at here is not a so-called auto immune response but the pathogens ability to induce inflammation to avoid & hide from the immune system .So again thanks be for anti-inflammatory's not forgetting the doctors that prescribe them ..Shortcut to: http://www.remicade.com/global/understanding/understanding.jspThe article conversely tells us that research in Washington University in St. Louis found that Crohn's disease responded to an immune stimulant.That's not a "U" turn so much as a backward somersault. Current treatment suppresses the immune system . http://aisweb.wustl.edu/alumni/atwu.nsf/crohnsSee alsohttp://www.mercola.com/2003/sep/13/inflammatory_bowel_disease.htmSt. Louis Post-DispatchNovember 8, 2002WU researchers have developed controversial Crohn's treatment By Tina Hesman(Reprinted with permission from the St. Louis Post-Dispatch)Half a million Americans structure their lives around being near a bathroom because of a chronic bowel disease. Now a controversial new treatment developed at Washington University may provide a better life to Crohn's disease sufferers. Two researchers are uncovering a possible cause for the lifelong inflammatory bowel disease that afflicts patients with diarrhea, severe abdominal pain, infections and sometimes complications that require surgery - in the worst cases even removal of the large intestine. And they propose to give immune system boosters to Crohn's disease patients - a therapy that some experts liken to treating heart disease patients with shots of cholesterol. The origins of Crohn's disease are something of a mystery, said Dr. K. Dieckgraefe, a molecular biologist at Washington University. "It's an idiopathic disease. 'Idiopathic' is Latin for 'we don't know'" what causes the disease, Dieckgraefe said. Dr. R. Korzenik, a gastroenterologist who works with Dieckgraefe, said the disease seems to have both genetic and environmental triggers. A person whose identical twin has Crohn's disease has a 50 percent chance of getting the disease. Smoking is a strong risk factor for developing Crohn's disease, and diet and other unknown environmental factors may trigger the disease in some people with a genetic predisposition, Korzenik said. Most researchers have come to think of Crohn's disease as the result of an immune system working overtime. The immune system launches an assault against the bacteria that live in the intestines, producing swelling of the intestinal lining. But Dieckgraefe and Korzenik think the problem may actually be a defect in the immune system's first-response team - bacteria-gobbling white blood cells that are part of the innate immune system. The researchers got the idea when they noticed that children with genetic diseases that disable parts of the immune system have a high incidence of inflammatory bowel diseases, including Crohn's disease. About a third of children with glycogen storage disease 1B or chronic granulomatous disease also had Crohn's disease, the researchers found. About a dozen immunodeficiency diseases also are associated with Crohn's symptoms, Korzenik said. Even more intriguing was the discovery that children with some of these rare immunological disorders stopped getting Crohn's disease after 1991, Dieckgraefe said. That was the year that a medicine called Leukine was introduced to treat patients with immune problems, including those with genetic disorders and chemotherapy patients. The drug, a naturally occurring protein called Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF), boosts the body's ability to make innate immune cells. Dieckgraefe and Korzenik proposed that patients with Crohn's disease might have problems dealing with bacteria that manage to penetrate the intestinal lining. Without innate immune cells to dispose of the invaders, the acquired immune system - including specialized cells such as T-cells - would valiantly try to fend off the wayward bacteria, making the patient sick in the process. The theory was bolstered by the discovery of a gene that predisposes people to get Crohn's disease. About 20 percent of Crohn's disease sufferers have a defect in the gene called NOD-2 or CARD-15. The protein produced from the gene is important for activating cells in the innate immune system, Dieckgraefe said. The idea was roundly rejected in the scientific community, but the Washington University researchers were convinced they were on to something. They got permission from the U.S. Food and Drug Administration to give the immune-boosting drug to a small number of Crohn's disease patients to see if it is safe. The researchers had some concerns about giving Crohn's disease patients immune stimulators. "Are we throwing oil on a raging fire? Are we going to make things worse?" Korzenik asked. So the scientists started small, giving patients a low dose of the immune booster. No one got sicker. So the researchers increased the doses. Still, none of the patients got worse. In fact, 12 of the 15 patients in the study did significantly better - dropping 100 points or more on a scale that measures Crohn's disease severity. Eight of the patients went into complete remission after the treatment. Perkowski, 40, a trompe l'oeil mural artist from Oakville, had been sick with Crohn's disease for 20 years when she joined the study. Before the study, her good days - days in which she had enough energy to do daily activities, her abdominal pain was bearable, and she didn't have to be near a restroom constantly - came once or twice per week. About two weeks after Perkowski started injecting herself with the immune stimulant, every day started to be a good day, she said. She visited the bathroom only once a day instead of 13 times as she had before. She didn't have to stop on her way to work to find a public toilet. "It was amazing. It was incredible," Perkowski said. She finally had control of her life, she said. But then Perkowski reached the end of the eight-week trial. A month later Crohn's disease was back in control. When her doctors gave a second round of treatment, Perkowski got the upper hand again. It was a feeling she didn't want to give up. "I was like a drug addict then. I said, 'Give me my shot! Give me my shot!'" Perkowski said. Some of the patients in the study have remained symptom-free for more than a year, Dieckgraefe said. Others, like Perkowski, relapsed when treatment stopped but got better again once the medicine was reinstated. Some mild side-effects, including bone pain from growing bone marrow, subsided after a few weeks, the patients reported. The results of the study, published today in The Lancet, are leading many Crohn's disease researchers to rethink their ideas about what causes the disorder, the Washington University team said. "I think this was an extremely important study because it opens a whole new concept of the pathogenesis of Crohn's disease," said Dr. R. Balfour Sartor, a Crohn's disease researcher at the University of North Carolina at Chapel Hill. "This is a provocative, preliminary study, but it's not ready for prime time." Sartor and investigators at 30 medical centers around the country, including Washington University, are recruiting Crohn's disease patients to participate in a larger clinical trial comparing the innate immune system boosters to a placebo. ======== Symptoms and facts Crohn's disease is an inflammatory bowel disease that attacks the large and small intestines. Symptoms may range from mild to life-threatening and include: * Persistent diarrhea * Fever and weight loss * Abdominal pain or cramps * Blood in the stool * Skin or eye irritation * Children with the disease may have delayed growth and retarded sexual maturation. * More than half of Crohn's disease patients require at least one surgery to deal with complications of the disease. Source: Crohn's and Colitis Foundation of America For more information about clinical trials with Granulocyte-Macrophage Stimulating Factor (GM-CSF), contact: * Study Coordinator: Arlyn Pittler * Washington University School of Medicine * 660 S. Euclid Avenue, Box 8124, St. Louis, Mo. 63110 * Phone: 314-362-9093 * Fax: 314-454-5107 Information about other clinical trials for Crohn's disease can be found on the Internet site of the Crohn's & Colitis Foundation of America Inc.: www.ccfa.org, or by contacting the local chapter at: * 314-991-0220. * Toll free: 1-800-783-8006 Reporter Tina Hesman; E-mail: thesman@...; Phone: 314-340-8325Copyright 2002, St. Louis Post-Dispatch, Inc.(To see the St. Louis Post-Dispatch online, go to http://www.stltoday.com)