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In this post we look at more problems that can occur in the gut. Plus find information on the therapeutic approaches that are making a difference to sufferers of gut problems.
What Triggers Inflammation in Gut?
If the cells run out of “air,” they work better. Hardly any element is as essential for humans as oxygen. Our cells notice a deficiency immediately and react. A research team from Heidelberg now wants to use these mechanisms to improve the treatment of ulcerative colitis.
Oxygen shapes our life from the first to the last breath. It plays a crucial role in generating energy in our cells. No wonder our cells react sensitively to a lack of oxygen. However, what is surprising is that this reaction enables starting points for a more effective fight against inflammation. The 2019 Nobel Prize in Medicine was awarded for the discoveries of the molecular mechanisms with which our cells react to a lack of oxygen.
Biomedical research is now focusing on how these mechanisms can be specifically influenced pharmacologically and used for better therapies. The international research team was led by the physician Professor Dr. Dedicated Martin Schneider from the University of Heidelberg with the support of the Federal Ministry of Education and Research (BMBF). “There is a great need for improved therapies – especially for young patients,” emphasizes Schneider.
What Helps Inflammation of the Gut?
Inflammation of the colon calls forth numerous immune cells. These require large amounts of energy for their work, which they usually obtain from oxygen. However, since there is a lack of oxygen (hypoxia) in the intestine, the immune cells have to change their energy metabolism. Like all cells in our body, they use sensitive oxygen sensors to do this. These perceive changes in the oxygen concentration immediately and primarily regulate the Hypoxia Inducible Factor or HIF.
The less oxygen there is, the more HIF accumulates in the cells. This protein then sets off a chain reaction of molecular processes. “We found out that the cells are better protected against inflammation when there is a lack of oxygen,” says Schneider. “The immune cells can migrate better to affected areas or kill bacteria.”
Gut Inflammation Research
Drugs can affect the corresponding oxygen sensors. Medicines based on it are already treatments for anemia. “With the help of these drugs, we can fool the cells into thinking there is a lack of oxygen,” explains Schneider. Just as with a natural undersupply, this increases the HIF concentration in the cells. “In preclinical tests, we have already shown that these active ingredients massively reduce inflammation in the intestine,” says Schneider. His team’s more detailed investigations have shown that HIF has various positive effects on ulcerative colitis.
On the one hand, fewer inflamed intestinal cells die, and at the same time, the cells produce more protective factors for the intestinal mucosa. Together, both effects strengthen the intestinal mucosal barrier, essential for a healthy intestine. Because when this barrier breaks down, gut bacteria freely invade surrounding tissues and worsen the inflammation.
Around 170,000 people live with chronic intestinal inflammation and ulcerative colitis in Germany. When this colon disease flares up, they suffer from bloody diarrhea, cramping abdominal pain, and nausea. The acute symptoms severely limit the quality of life of those affected, who also have a significantly increased risk of colon cancer. So far, they cannot cure the disease, and the drugs used sometimes have severe side effects. If the course is intense, parts of the intestine may even have to be surgically removed.
What Triggers Inflammation in Gut?
However, caution is advised. The HIF protein controls various cellular processes, including some that cancer cells use to form tumors. With the help of HIF, tumors can grow new blood vessels to supply them with nutrients and metastasize more easily. The regulatory network with which cells react to a changing oxygen supply includes a complex interaction of HIF and other factors. “We have to find out as precisely as possible what role each factor has if we want to understand the network,” explains Schneider. “Only then can we use the positive effects in a targeted manner and at the same time prevent a cancer-promoting effect”.
The first clinical trials for the treatment of ulcerative colitis are in preparation. The researchers’ primary goal is to improve the quality of life of those affected as quickly as possible through new drugs.
Gut Inflammation Research – forecasts for therapy decisions
A more detailed understanding of the regulatory network should also enable significantly better prognosis methods that can predict the course of the disease individually. Small intestinal mucosa samples are regularly taken from patients with chronic intestinal inflammation. Researchers can use mathematical methods to analyze the number of individual components of the network in the samples. The distribution of the various factors allows statements to be made about the severity of the disease.
Above all, this enables physicians to more precisely assess the risk of colon cancer in those affected. “A reliable prognosis is essential for those affected,” says Schneider. “Serious procedures such as removing the colon are better tolerated for those affected if they know as positively as possible that it can prevent cancer.”