Researchers from the UNC School of Medicine have discovered that there are two subtypes of Crohn’s disease. This provides an explanation for why the intestinal disorder can be so difficult to treat. The findings may lead to improved treatment methods. The details are in a paper that was just published in the journal Gut.
Crohn’s disease is an inflammatory bowel disease that results in symptoms such as diarrhea, abdominal pain, and fatigue. It can affect any part of the digestive tract and there is no cure. The disease, which has a genetic component, is difficult to treat. Some patients respond to medication while surgery is an option for other people. Patients with Crohn’s disease are more likely to develop colorectal cancer. Crohn’s disease, which affects about 700,000 Americans, is poorly understood.
A team of scientists studied tissue samples from 21 patients with Crohn’s disease. The team made a surprising finding: there were two genetically distinct “versions” of the disease. These subtypes had different patterns of gene expression and resulted in separate sets of clinical symptoms. One subtype referred to as “colon-like” was more likely to cause rectal disease and severe colon inflammation that required surgery to correct. Since the original sample size of 21 was small and had some problems (all of the tissue samples were from patients that had undergone surgery), the team confirmed their results with 201 additional samples. The new tissue samples, from children who had been diagnosed but not yet treated, still showed the same two subtypes.
Crohn’s disease has always been difficult for doctors to treat. The discovery of two separate subtypes explains why some patients respond to treatment while others require different forms of therapy. The research team’s findings should help scientists develop better treatments for the disease. Doctors could treat patients based on their disease subtype, allowing for customized therapy and medication. The original research team has already received funding from the National Institutes of Health to conduct a larger-scale study.
Weiser et al. Molecular classification of Crohn’s disease reveals two clinically relevant subtypes. Gut (2016).