What’s New in IBD Research in 2022?

Scientists are learning more about Crohn‘s disease and ulcerative colitis each year.

New research is constantly emerging on inflammatory bowel disease (IBD). The two main types of IBD are ulcerative colitis (UC) and Crohn’s disease.

There have been a lot of new developments in treatments, management, and condition research in 2022.

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Disease and treatment management

Once diagnosed, IBD is usually managed in a combination of different ways, from 5-ASA medications to immunosuppressants and biologics to surgery.

But knowing what treatment is best for you isn’t always easy.

Some people may not respond well to certain therapies or develop secondary health problems due to their IBD, such as skin, eye, liver, and bile duct issues.

A new blood test

Recently, a group of scientists at the Francis Crick Institute in London developed a blood test called Predict SUREIBD that was reported as 90 percent effective at assessing the disease severity of IBD.

The blood test works by assessing the levels of immune cells, called T cells, in a person’s body. It has the potential to predict future flares before they occur, meaning that people could quickly be put on an appropriate treatment plan and avoid invasive procedures like colonoscopies to assess flares.

While the blood test was not approved for financial funding by the NHS, its existence may serve as a potential future management tool for people with IBD across the globe.

Stem cells

Research has also emerged on the potential for regenerative and stem medication to manage IBD.

Unlike treatments that work to suppress the immune system and inflammation, stem cell medicine may work by promoting intestinal healing and regeneration.

Stem cell research and medications that block molecules that contribute to gut barrier dysfunction were proposed in April of this year.

Monoclonal antibody medication

New medications have been showing promise for their effectiveness for IBD.

According to the Jansen Pharmaceutical company, new drugs Stelara and Tremfya have been shown as effective long-term treatment options. These drugs target and bind to inflammatory compounds to reduce their activity in the body.

Also promising are phase 3 trial results from Eli Lilly and Company for monoclonal antibody medication mirikizumab used to treat ulcerative colitis. It showed that 50 percent of people with severe UC activity achieved remission after 1 year of taking the medication.

Extraintestinal manifestations

IBD can affect other parts of the body like the skin or eyes, called extraintestinal manifestations (EIMs).

There’s new evidence for the potential use of JAK and interleukin inhibitors to treat them rather than steroids and immunosuppressive drugs. These inhibitors work by blocking the activity of the JAK enzymes and interleukin molecules that contribute to systemic inflammation.

Disease mechanisms

A large part of helping people with IBD involves understanding how and why the condition occurs.

Microorganisms

A previous infection of the gastrointestinal tract is a known risk factor for developing IBD.

However, a 2022 analysis found that previous use of antibiotics was also a risk factor for developing ulcerative colitis. The research suggests that the more antibiotics a person takes, the more their risk of developing UC increases because antibiotics disturb the balance of the gut microbiome.

Meanwhile, an earlier study in 2022 suggests that a toxin called candidalysin released by a fungus in the gut results in inflammatory responses and immune cell activation. The responses to the toxin can contribute to the development of inflammatory bowel disease.

These studies imply that a disturbance of the gut microbiome could be an important factor in the development of IBD.

Immune system dysregulation

Dysregulated immunity — aka when the immune system attacks its healthy cells — is a large part of IBD and all autoimmune diseases.

Researchers have taken this knowledge further in their 2022 discovery of dysregulated B cell production, proliferation, and humoral immune response in people with ulcerative colitis.

Humoral immunity is the antibody-assisted immunity that’s often known as adaptive immunity. It’s responsible for responding to foreign invaders and pathogens. It produces antibodies and other components as defense mechanisms.

But in autoimmune diseases like IBD, these humoral and adaptive systems do not work properly.

A study in December 2021 found that a dysregulated immune system may also contribute to intestinal fibrosis, a common complication of IBD where scar tissue develops on intestinal walls.

They found that the dysregulated release of certain proteins or a change in the protein genetics in the intestines can lead to intestinal fibrosis.

This fibrosis and thickening is a well-known complication of IBD, particularly in Crohn’s disease.

Genetics

Autoimmune diseases have a genetic component — they often run in families and someone with one autoimmune disease is likely to develop others.

Genes for IBD have been connected with other genes that predispose someone to type 1 diabetes, autoimmune hepatitis, rheumatoid arthritis, Graves’ disease, psoriasis, ankylosing spondylitis, and more.

Someone with IBD has a higher chance of developing other autoimmune conditions like these.

In recent years, one of the main co-occurring conditions associated with IBD has been multiple sclerosis (MS).

The connection between the two had been suggested as early as 2000, but the first study to quantify this comorbidity risk was published in 2022. The researchers identified three genetic variations commonly found in people with both conditions. They suggested all people with MS and IBD be monitored for the development of the other condition.

Scientists also identified genes that predispose someone to extraintestinal manifestations of IBD.

What does this all mean?

Every year, scientists understand more and more about IBD.

Their work helps us understand more about why and how IBD occurs, as well as the genetic risk factors for its development and the development of related autoimmune conditions.

A better understanding of IBD allows for the potential to develop treatments and medications that can make Crohn’s and UC management easier.

To stay up to date on the latest research, check databases like the Nature Portfolio, which has open access to hundreds of the latest studies on IBD.