The following article appeared in the 2015 Crohn’s and Colitis Canada Gala Magazine, of which RedHill Biopharma was a Gold level sponsor. Interestingly, the article updates the two areas that Prof. Borody believed (in 2008) would be the key to future MAP research: detection methods and trials of MAP specific antibiotics.
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Many of you may have already watched Prof. Thomas Borody’s nine part video series in which he discusses the role of Mycobacterium avium subsp. paratuberculosis (MAP) in Crohn’s disease and answers a myriad of questions. The series, which is about 90 minutes, is still relevant today, though some information may be outdated. For those who don’t have the time to watch it in its entirety, we’ve done our best to summarize some of the key points. We’d encourage you to see for yourself what Prof. Borody has to say, and why his approach is resulting in a much higher rate of remission than any other Crohn’s disease therapy.
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On February 26, 2015, the Advisory Committee on Dangerous Pathogens in the United Kingdom published a review of the latest research on the possible link between Mycobacterium avium, subspecies paratuberculosis (MAP) and Crohn’s disease. The last such review, conducted in 2005, determined that there was no evidence to connect MAP to Crohn’s disease. That was not the finding in the current review done a decade later. Read on to see what the ACDP found.
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We are at the dawning of a new era in the use of antibiotics.
For some 20 years there have been attempts to use antibiotics in the treatment of Crohn’s disease. Although most trials have delivered mixed results, this direction has been reinforced by the association of Mycobacterium avium ssp paratuberculosis (MAP) with Crohn’s disease.
The main principle of judicious and effective antibiotic usage has been the targeting of the suspected pathogen with a therapy that is both specific and directed. This has been a difficult job, as there has been, up to now, no protocol that will ensure the reliable isolation of the pathogen from the patient. The model that is used for new compounds against MAP-associated organisms is directly related to the proven therapies for tuberculosis, and this has been a wise model to follow.
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I know everyone is patiently awaiting the video replay from the symposium last week, and we hope to get it on the website this week! Also coming soon: a MAP forum partnership where you can share your stories, treatments, theories and ideas about everything MAP. Sign up and stay connected to the latest developments and others like you. While we wait for the video, here are a few thoughts from a humble audience member.
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Immune Modulating Drug Stimulates Innate Immunity, Down-Regulates Unproductive Inflammation and Promotes Th1 Immunity People have asked for more information on Formulated EpiBro (FepiBro). A formulation of 16-bromoepiandrosterone (Epi-Br) was originally developed and investigated under the name HE2000. There is extensive literature on its activity against infectious diseases. It underwent human trials as an immune modulating drug designed to combat the major infectious diseases in the “Developing World.” The HE2000 formula demonstrated activity against HIV/AIDS, malaria and tuberculosis in nine human trials. It was shown to be safe and effective. Read on to see why it wasn’t further developed and why it could now help Crohn’s disease patients.
My memory is not as polished as it was at age 30. I can still recite entire speeches from Shakespeare, but I sometimes forget to pick up the dry cleaning. Though I have a large brain and many neurons to assist my powers of recall, I question how the immune system retains it’s memory. My immune system has been “primed” to recognize threats to my health, and also to keep my body in generally good shape over a lifetime. In order to properly fight infections, the immune system needs to distinguish between the invaders and the beneficial bacteria.
Evolution is a random process, not always directed at benefits to both parties. One thought that has been occupying my mind is: What if a new pathogen was introduced into a well-balanced immune system, which then evolved to mimic a beneficial mycobacteria species, but with a sinister intent? Immune memory would be of no help at all.
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I suppose everything is real to the cat. I was watching our cat sleeping the other night, and he suddenly started twitching in his sleep. He appeared to be dreaming. Maybe our cat can distinguish between the reality of waking life and the world of the dream. In all probability, he cannot grapple with abstract concepts. He probably doesn’t wonder at all about where the food on the plate came from prior to being placed in his bowl in the morning. For our cat, reality is very concrete.
For a Crohn’s disease patient, reality is far from concrete. The reason they have become ill is not yet understood by the medical profession, and there are any number of theories that can be presented to the patient to explain the age old question, “Why me?”
Internationally, New Zealand seems to be a desired destination. We have a thriving tourist industry, tempting tourists with a multitude of ways to place their lives in danger. Unfortunately, there is not the same attraction for career scientists, partly because of funding and partly because of remoteness from the centres of international research excellence. The adventurous spirit seems to be implanted in our genes. As a Boy Scout, I had frequent expeditions into the wilderness, usually in a small team of others near my age. I learned the value of working in a team to achieve a goal. Like in Boy Scouts, the most cost-effective way to advance in research is to form teams.
See how John Aitken’s exceptional team has been able to accomplish critical Crohn’s disease research despite encountering many obstacles.
Experiments have two primary outcomes, either confirmation or rejection. There is, however, a third outcome – The Unexpected. Luck never actually appears in publications as a contributing factor. The lucky observation is the catalyst. Some of the most significant discoveries made in microbiology were flukes of luck. Sometimes, trial and error leads to a point where the experiments narrow down. This can happen when you get lucky. I think it happened to me.
Read on to find out how John Aitken first became interested in Crohn’s research and see how a little bit of luck has led to some of the most important scientific discoveries.
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