Crohn’s Disease: Too Much, or Not Enough?

A longstanding question in for those studying inflammatory bowel syndromes: Is Crohn’s disease an autoimmune disorder?

Crohn’s disease has become a prolonged enigma, the authors wrote, although it is considered by many to be a mixture of genetic predisposition and the effect of the body attacking its own immune system.
But Segal set out to test another hypothesis — that bacteria spreads and inflames the intestines due to lowered immunity in the body – and so he and colleagues took the unusual approach of inflicting trauma, in the form of biopsies and skin scrapings, to Crohn’s patients. He then observed how their white blood cells responded.
Segal first took two biopsies at six hours apart from the rectums of Crohn’s patients and a control group of healthy people. He noticed that the inflammatory response to the trauma was only a quarter of what it should be, and that no neutrophils were present. Neutrophils are white blood cells that provide the first line of defense against foreign invaders in the body…
To boost this evidence of a failed immune response, and to find if the phenomenon only occurred in the bowel region, the scientists also sandpapered patients’ skin to see how cells responded. Again, they found very few neutrophils rushing to the trauma on the skin, even after 24 hours. This revealed a “systemic general abnormality, not a one-time (response),” Segal said.
In the last test, the researchers injected Crohn’s patients with killed e. coli bacteria, to find out if their bodies had abnormalities in dealing with bacteria. In normal people, there was a florid inflammatory response, with a tenfold increase in blood flow, but in Crohn’s patients, the blood flow was weak at best.

Fundamental stuff that might open the door to new therapies — such as Viagra (no joke) for boosting tissue perfusion and thus, immune access to areas of inflammation.
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