Among the causes of IBD, the reason of stress seems to me too broad and therefore too hard to define. What is the ultimate standard for acute and chronic psychological stress? There are too many variations to be considered when we focus on this cause, in addition to the duration and intensity of different types of stress, each individual has different levels of tolerance when we deal with stress. All of these reasons revealed the difficulties when one tries to associate stress as the main cause of IBD.
The uncertainties of relating stress to IBD led me to research for other causes to this disease. There are many studies out there focused on relating IBD to genes. It seems as many scientists have known for a long time that IBD is related to genetics, and the evidence revealed that IBD tends to run in families. Different studies have shown the result of gene mutation on different genes and scientists believe that this disease is not caused by merely one particular gene but many different ones. New genes that are believed to lead to IBD are continually discovered and various genes mutations contribute to the different severe forms of the diseases.
One article[1] indicated that IBD that begins in childhood appears to be more severe than adult-onset IBD and is more likely to attack the colon than other areas of the GI tract. This fact motivated the researchers to study and analyze the genomes in childhood-onset disease, they found gene variants on both chromosome 20 and 21. The specific gene TNFRSF6B on chromosome 20 is known to participate in the tumor necrosis factor (TNF) biological pathway --- one of the cytokines that plays an important role of IBD. The researchers believe that with better more in depth knowledge of the disease pathway and all possible genes that are involved in forming IBD, it will increase the possibility of treating this particular disease by developing anti-TNF drugs that could be customized to each patient regarding to their own genetic profiles.
Although it is still not a well-understood disease to date, the ultimate goal for the researchers and scientists is to identify all the potential genes involved, their interaction with each other as well as environmental influences in IBD formation. Once the goal is achieved, the development for personalized treatments to patients will be possible.
For further reading on different studies regarding to IBD…
[1] http://www.medicalnewstoday.com/articles/119849.php
[2] http://www.medicalnewstoday.com/articles/138667.php
Robert N. Baldassano, M.D., director of the Center for Pediatric Inflammatory Bowel Disease at The Children's Hospital of Philadelphia.
Study Leader Hakon Hakonarson, M.D., Ph.D., director of the Center for Applied Genomics at Children's Hospital.
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Hey Sunny,
ReplyDeleteI agree that the stress connection to IBD is loose. The review paper on stress and IDB really works itself into a lather trying to show how they are related but I don’t think they did a very good job. Actually I short of think that despite their conclusions they just showed they really don’t have any real evidence. For example long term stress is anti-inflammatory but by some unexplained happenings it causes the harmful inflammation in IBD. They also suggest that long term stress is synonymous with consecutive bouts of short term stress. Sorry but the stress of jumping into the freezing ocean at 5 AM to go surfing and the stress of a semester of late nights at the library are not the same thing. Anyway could you tell me more about the genes you found related to IBD? Like does it cause more TNF?
There are many research articles out there working on studies of different potential genes that may play a role in IBD; however, the end results from various studies are actually very controversial!
ReplyDeleteSome of the researchers and scientists do suspect the possibility of abnormal production (increased production) of the TNF. There is one article that I read which focused on the polymorphism of TNF gene in Crohn’s Diseases, in this particular study, a significant increase of TNF2 allele frequency was found in patients. The TNF2 has been described in several infectious diseases associated with high production of TNF-α, in addition, some anti-TNF drugs were tested in studies but shows either improvements in CD patients or no help at all.
So…again! There are a lot of articles but there isn’t a confirmed mechanism of TNF’s role in this disease yet. Just as we talked about in class, it is still a pretty new area for researchers!