Study May Lead to Novel Therapies in Children With Recurrent Crohn Disease

New research conducted by investigators at the University of Virginia (UVA) Health System and published in Scientific Reports may explain recurrent Crohn disease in children, and it may open the door for novel treatments. 

Although Crohn disease is most common in adults, it still impacts tens of thousands of children in the United States alone. Many of those affected struggle to go to school and find their quality of life diminished. These children, the researchers noted, can also suffer stunted growth and delayed puberty and may need to have sections of their bowel surgically removed.

Working under the guidance of the UVA School of Medicine’s Chelsea Marie, PhD, Rebecca Pierce, then an undergraduate student, discovered that children with relapsing Crohn disease had a persistent disruption of their microbiomes even after inflammation was controlled by treatment.

Pierce, now a medical student at Georgetown University, and her colleagues compared biopsy samples collected from the intestines of children with Crohn disease who had gone into remission with samples collected from a control group of children with no signs of Crohn disease.

The study uncovered notable differences, with children with Crohn disease exhibiting significant decreases in bacteria, such as Streptococcus, and increases in others, such as Oribacterium, which has been linked to gut microbiome disruptions. Moreover, the investigators observed notable changes in immune cells, such as an increase in the numbers of CD4+ T cells, which play an important role in inflammation.

Furthermore, and perhaps counterintuitively, children with Crohn disease had stronger barriers of epithelial cells lining their intestines. This finding indicates that existing treatments for Crohn disease are effective but not fully addressing the underlying issues that drive the disease.

“The relationship between dysbiosis and inflammation is a long-standing question in Crohn disease. Rebecca leveraged a pediatric cohort at UVA to show dysbiosis was present even when gut inflammation was controlled,” said Dr. Marie in a press release. “Our study suggests that persistent microbial imbalances might be an important factor in the disease course in children.”