Ineffective interleukin-10?

The Atlanta Journal-Constitution reports that a small study of children with severe colitis has found a genetic mutation that reduced the effectiveness of interleukin-10 in their immune systems. Researchers are now considering whether a subset of adult Crohn's cases have a similar cause. If so, then a more direct treatment could be found.

One child in the study was completely cured by a bone marrow transplant. Although such transplants have been used for severe Crohn's cases, they are highly risky. This research should assist in determining the efficacy of such a treatment.

Interleukins have been implicated in Crohn's in the past, but this is the first study to target IL-10 in particular. It has been suggested that Crohn's is a blanket term for a variety of IBD conditions of various causes, and this research is another indication that this may be true.

Recent developments

Hidden behind the subscription wall of The Wall Street Journal is a nice summary of the current status of the various Crohn's treatment options. That article has now made its way into the free world via the naplesnews.com.

Amongst developments not yet reported in this blog is news of medicine which is potentially better than the highly-regarded anti-TNFs gaining popularity today. These include arthritis drug Orencia, interleukin-12 and interleukin-23 (interleukin has been mentioned previously), and a drug using adult stem cells.

Besides anti-TNFs, there is a rheumatoid arthritis drug from Bristol-Myers Squibb, called Orencia, that is being studied for Crohn's disease. The drug works on inflammation earlier in the process than do anti-TNFs. Bristol started the final phase of human testing of Orencia against Crohn's last month and is currently enrolling patients in a trial.
...
J&J and Abbott are working on drugs that inhibit two proteins called interleukin-12 and interleukin-23. Both companies are in the middle stages of human testing. Strober, of the National Institute of Allergy and Infectious Diseases, says the benefit could be tackling inflammation much earlier in its development than the anti-TNFs do, but that the drugs could carry an increased risk of infection.
...
Osiris Therapeutics, based in Baltimore, just got approval from the FDA to go into the third and final phase of human testing on a Crohn's drug that uses adult stem cells. The company says the agency gave the drug fast-track status, which means it could come to market as early as 2008.

The drug is thought to work by correcting inflammation only where it's taking place — which could help avoid excessive immune suppression.

Interleukin receptor mutation found

A variety of media outlets have covered the new research that has found a gene mutation relating to the inflammation protein interleukin-23. (The roles of the different interleukins are summarised in the Wikipedia.) In this study, the DNA of people with Crohn's was compared with that of people without Crohn's. A mutation in the interleukin-23 receptor was one of their findings.

The BBC notes:

The fault is in a gene receptor present in healthy people without inflammatory bowel disease but rare in those with the condition.

Further background is provided by the Baltimore Sun:

In 2001, scientists identified the first major gene underlying Crohn's disease. Called Nod2, the gene regulates the immune system's response to bacteria in the gut. People with one flawed copy have twice the normal risk of developing the disease, researchers found. Two flawed copies and the risk jumps 20- to 40-fold.

Researchers have since uncovered a handful of other suspicious gene mutations thought to play a role in inflammatory bowel disease. But the new finding marks the first time researchers have identified a mutation that may actually help protect against Crohn's.

The potential result of this finding is better drug therapies, eventually.