A Wormy Way of Life

I too, was unable to access the article Zoe recommended us read regarding worms as treatment for IBD. However, I did find another article on WebMDHealth pertaining to the same information. This article plainly states that “Parasitic Worms Ease IBD.” It briefly explains the wormy treatments and research for IBD conducted under gastroenterologist Robert W. Summers, MD, of the University of Iowa, College of Medicine. Several IBD patients are administered thousands of eggs of Tichuris suis, the “whipworm” (named for its whipping tail) found in pig intestines. The initial treatment with these patients shows evidence of a boost in their quality of life and also a decrease in symptoms. However, their symptoms do return. As a result, Summers increases the dosage every two weeks. In the end he states, “Some patients have continued getting the doses for years now and are doing well. And we have yet to detect any side effects in any patient.”

Although, the research carried out by Summers was fascinating to read that wasn’t what caught my attention with the article. I don’t know about any of you, but I was always taught that cleanliness was the key to a disease free lifestyle. Well this article made me rethink that theory and childhood teaching. The article explains that underdeveloped countries with insufficient sanitary conditions are without diseases such as IBD. Researchers suspect that the nonexistent diseases are due to parasitic worms, “helminths,” that live in the intestines of humans and animals. In contrast, industrialized, developed nations such as the U.S. lack helminths, therefore, countries without these parasites run rapid in IBD. Summers says to WebMD, “In fact, Crohn’s and ulcerative colitis really emerged in the U.S. during the 1920s and 1930s, when we began to shift to improved plumbing and sanitation and we no longer fertilized soil with both human and animal waste. Until then, these parasites were very common. And we didn’t have much IBD.” Now, isn’t that interesting? Made my eyes bulge out. So pretty much, Cleanliness = Disease; Dirtiness = Health. Hmmmm!

http://www.medscape.com/viewarticle/537189

Stroke: Domino Effect

We all understand that a stroke occurs when a blood vessel in the brain becomes blocked by a clot or bursts, eventually leading to decreased O2 and glucose supply to that particular brain tissue. As a result, this tissue will either become damaged or die. However, according to Lauralee Sherwood, there is a lot more to the causes of brain damage than what’s been told. She calls it “A Deadly Domino Effect.”

Some recent findings suggest that neurotoxic effects create a broader area for cell death. In other words, not only are the initial blood-deprived cells dieing by necrosis (accidental cell death), but their neighboring cells are also subject to apoptosis (intentional cell death). There is a cascade of events that begins with the initial O2 deprived cells which releases enormous amounts of glutamate, a common excitatory neurotransmitter. Normally, it is dispersed in small amounts, enough for chemical communication between brain cells. The excitatory glutamate overproduced and released by the damaged brain cells attaches to and overexcites bordering neurons. Glutamate specifically likes to bind with NMDA receptors, which function as Ca2+ channels. The toxic activation of these receptor-channels causes the channels to remain open longer which allows even more Ca2+ to flood into the affected neighboring neurons. As a result, the elevated levels of intracellular Ca2+ activate the apoptosis of these cells.

But wait, there’s more. The Ca2+ apoptotic signal is speculated as spreading from dying cells to adjoining healthy cells. This job is accomplished through gap junctions, cell-to-cell conduits that permit the diffusion of Ca2+ and other small ions between cells. Overall, what does this tell us about a stroke? The majority of neurons that die following a stroke are originally unharmed cells that commit suicide in response to the chain of reactions unleashed by the toxic release of glutamate from the initial site of O2 deprivation.


Sherwood, Lauralle. Human Physiology 6th Ed. United States: Thompson Brooks/Cole, 2007.

Smoking and sugar intake are seperate but interactive risk factors in Crohn's Disease

Hi Everybody. I was intrigued and a little disturbed by this article, which talked about the association between sugar consumption, smoking and Crohn's Disease. They used added sugar as an estimate because it is highly correlated with overall refined sugar intake, typically making up about half of it. Furthermore, smokers take in about one-third more sugar than non-smokers. Both smoking and sugar intake are environmental factors associated with CD. On a more personal note, when I was younger I experimented with smoking and NOW I know that I am one of those people who loves the most "sugared down" coffee you can imagine. Also, IBS is in my family on both sides. Is this enough for me to lower my sugar intake?? Probably not, at least when it comes to coffee, but it is making me think twice. So next time you are making coffee or tea, think about this. =) Have a great week!

TNF in Crohns

Hi Class,
I found some interesting information on the relationship between Crohns and TNF alpha. As we all know, TNF alpha plays a role in chemotaxis of white blood cells to fight infection or pathogens. A somewhat new drug, Infliximab, is FDA approved and is used to very selectively target and antagonize TNF alpha . Antagonizing TNF alpha would disable the release of cytokines such as interleukin 1 and 6, and therefore slow the inflammatory process to a large degree. The advantage with this type of antagonizing drug is that it is not necessary to damage the immune system, as is the case in other treatments. Here, TNF can be selectively targeted while leaving the rest of immunity undamaged. I have a friend with Crohns and he is actually taking a low dose of chemotherapy to control it; this tends to destroy many T-cells and other leukocytes and so it takes him weeks or months to get over illness. With TNF inhibitors, time periods can be allowed where the patient can stop treatment and be allowed to fight any sort of illness or pathogen. Also interesting with this friend is that many of the dietary treatments we discussed in class last period, such as yogurt, milk, and certain vegetables are actually triggers for his type of Crohns. This makes controlling it even more difficult and on top of that, he cannot take calcium supplements because that too triggers inflammatory response. A TNF blocker may be beneficial for many patients, however, it has limitations as do all treatments.

Unusual Treatment for IBD

Hey everyone-

I found an article about an unusual treatment for IBD. Apparently, cannabis can alleviate symptoms of IBD. A group did some research on why, and they had some interesting findings. They looked at two specific receptors in the gut, CB1 and CB2, which are activated by cannabis. CB1 is present in healthy individuals, but CB2 is more prevalent in people that suffer from IBD. CB2 levels actually increase as the disease progresses.

CB2 might be linked to apoptosis, and to suppressing an overactive immune system. Therefore activating this receptor might reduce inflammation by getting rid of excess cells. CB1 is associated with wound healing in the gut.

However, they are not looking to use "herbal cannabis" as a treatment because of its legality. There are molecules called "endocannabinoids" that occur naturally in our bodies, so fiddling with this built-in system is the probable path to be pursued in cannabis based treatment of IBD.

Here is the article: http://www.medicalnewstoday.com/articles/28584.php

Inflammatory Bowel disease: past, present, and future

Hi everyone:D
A couple of things from this article caught my attention. Prior to reading this (and a few other papers) I had heard of Crohn's disease, UC, and IBD but I didn't have very much knowledge about them. So I found it interesting that in IBD basically the immune system kicks into high gear because it recognizes its own intestinal flora as a pathogen. This elicits an immune response without the ability to down regulate it.
There are inflammatory cells that in the intestinal mucosa that reside at the interface of systemic circulation and the intestinal epithelium. These cells are waiting for some sort of infection to occur to initiate the an inflammatory response. Patients without IBD have controlled continuous inflammation in their intestine however, those with IBD and the like have no ability to control it.
Interestingly enough there are genetic factors that play into this disease. Some people have a predisposition to becoming infected with this disease more than others. Obviously, environmental factors have influence on the development of IBD to include exposure to microbiota.
What I found most interesting in this article was the different types of treatment currently under research. Enteric bypass was used in the 1980's to alleviate symptoms of Crohn's disease, but this was later developed into ileal punch-anal anastomosis.
This paper then continues on to attempt to explain what is happening physiologically in this disease as far as lymphatic intervention.
Investigational research includes either inhibiting or upregulating key factors in the lymphatic signaling processes in an attempt to return bowel inflammation to normal conditions. All in all I thought this was a good paper:D

Surgical Intervention for Neonatal and Infantile-Onset Severe Colonic Crohn's Disease: Report of Three Cases

Hey Class! I wanted to share this article I found because I think it puts the disease in perspective of how pervasive it can be and its application to children. Crohn's Disease is not usually diagnosed at young ages but rates are continually increasing. This paper describes three cases individually who were medically therapy - resistant and had extremely poor qualities of life. I did not want to post the summaries of the three cases because it is definitely something worth reading (only 4 pages). The patient's initial non-responsiveness to some very strong and intensive steroid approaches clearly represents the intensity that this disease can have. The paper describes how side effects of steroidal use (potential treatment approach) caused mental retardation, moon face, growth retardation, malnutrition, fatty liver, and many more. The patients ultimately turned to surgical approaches and as a result increased their qualities of life as best as possible. Surgery is not always an attractive option, but in these cases it was the most successful because it allowed them to refrain from additional steroidal use.

One of the interesting points made is that "none of the cases had an immunodeficiency, which is an important differential diagnosis of IBD in this age group. Thus, may be caused by different underlying inflammatory mechanisms in early onset CD compared with typical adult cases." This statement alone represents that developments to the understanding of the disease are being made, which possibly opens up new research avenues.

Note: this article is very recent; released February 2008!

Here is the link to the article:
http://ezproxy.library.arizona.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=28838658&site=ehost-live

Click on article linker (on the bottom right) and when the window opens up, on the right there is a link that says pdf full text :)