A 180-degree Turn for Crohn's Treatment, is Arthritis Far Behind?

Crohn's disease is an inflammatory bowel disease (IBD), the general name for diseases that cause inflammation in the intestines. It occurs in men and women equally, and produces a host of terrible symptoms including inflammation in the small intestine. This can lead to pain and chronic diarrhea. Crohn's disease affects 500,000 Americans, and has been regarded as a baffling condition. Recently, however, scientists have found hope for the condition in Leukine (sargramostim), which seems to improve conditions in patients with the disease. This may seem like a far-off issue for those with arthritis, but the new treatments and approaches have potentially far-reaching implications for those suffering with autoimmune conditions such as Rheumatoid Arthritis as well.

Perhaps the most interesting aspect of the Leukine treatment for Crohn's disease is that it seems so counter-intuitive. That is to say, many medical experts and researchers thought that using a drug such as Leukine is the last thing one would try with a condition such as Crohn's. Crohn's disease is though to be caused by the body's immune system reacting to a bacterium or virus by causing ongoing inflammation of the intestine. As a result, many doctors blamed the condition on an over-active immune system, and prescribed immunosuppressants to treat it. The goal would be to slow down the immune system's reaction, and thus relieve inflammation. An example of an immunosuppressant would be Remicade (infliximab), a drug which is popular for treatment with Rheumatoid Arthritis. Remicade works by reducing the level of a chemical in the body called tumor necrosis factor alpha. Tumor necrosis factor alpha is a key factor in the inflammatory process that occurs in rheumatoid arthritis and Crohn's disease.

Leukine, however, takes an opposite approach. It strengthens immune response by increasing the size and function of white blood cells, and strangely enough, this has helped ease and even eliminate the symptoms of Crohn's disease. Researcher Joshua Korzenik, MD, of Washington University School of Medicine and a Crohn's specialist at Barnes-Jewish Hospital in St. Louis said in a study published in the November 9, 2002 issue of The Lancet, "...people were saying that the idea of stimulating immune systems that are already revved up is like throwing oil onto a raging fire. While this treatment approach certainly isn't prime-time yet, we're extremely excited because it offers a different approach and new understanding to a disease that has defied explanation."

Leukine is manufactured by Berlex, Inc. and is primarily used for treatment of leukemia. Berlex has recently begun a series of clinical trials to gauge the effectiveness of Leukine in treatment of Crohn's disease. The trials are being staged in phases referred to as N.O.V.E.L., or New Opportunities to Verify Evolving Logic in Crohn's disease.

In the meantime, other drugs are still being used and still host very positive results. "Remicade requires continuous infusion, whereas Leukine is injected, so it's a lot easier to administer," notes Seymour Katz, MD, of New York University School of Medicine and a spokesman for the American College of Gastroenterology. "Does this mean that Leukine is the only answer for Crohn's? No. Does it offer some hope for Crohn's patients? Yes. Is this an exciting finding that brings a new approach to treatment? Absolutely."

This holds exciting promise not only for those suffering with Crohn's, but others who face debilitating diseases related to the immune system, like Rheumatoid Arthritis. This new approach to treatment of immunological disorders may well have a future with arthritis in its many forms.