There is an urgent need for new and better treatments for people who suffer from Inflammatory Bowel Disease (IBD), a group of disorders that includes ulcerative colitis and Crohn's disease. Currently, IBD affects 3 million people, according to the Centers for Disease Control and Prevention. Since the causes of IBD remain unknown, most therapies are directed against inflammation, but a better understanding of the basic mechanisms will allow more meaningful treatment for patients. An in-depth, 10-year study of immune mechanisms by researchers at the Rutgers Robert Wood Johnson Medical School, however, may have both identified a marker of IBD as well as a potential treatment option.
Published in Science Immunology, Principal investigator Derek Sant'Angelo, PhD, associate director of basic science at Robert Wood Johnson Medical School's Child Health Institute of New Jersey, along with first author Agata Krzyzanowska, a doctoral candidate at Rutgers University, and colleagues discovered a new immune cell in the intestine that specifically prevents inflammation in model systems. Inflammation in the intestine can trigger diseases like IBD and is often caused by something in the outside environment-;what we eat, according to Dr. Sant'Angelo.
Dr. Sant'Angelo explains that while prior research has shown there are immune cells, called T cells, in the intestine, exactly which T cells controlled the disease was thought to be random. He continues, "It is impossible to target something that happens at random, so cellular therapy or treatment wasn't an option until our study suggested the cells were not random at all but had a purpose."
The researchers found that there is a dedicated type of T cell that is essential for protecting the intestine against inflammation. Further, the likelihood of having IBD was directly correlated to having fewer of these protective T cells in the intestine.
This discovery has important potential clinical implications for identifying those at risk for developing Inflammatory Bowel Disease. Says Dr. Sant'Angelo, "Because we can identify the specific cell, we can track the frequency of that cell and predict who could get sick. For example, if testing shows that a patient has lower levels of this T cell, that person could be more likely to develop IBD. If identified, preventative measures can be adopted before harm is done." Currently, there is no predictive marker for people who suffer from IBD.
The new discovery could also be used for a potential treatment. Using cellular therapy, the protective T cells could be transferred to people with IBD, increasing their normally low levels. Dr. Sant'Angelo considers this type of cellular therapy to be a very viable option for treatment.
The limited treatment options have plagued people who suffer from IBD. While it will be some time before clinical trials are ready, I'm optimistic that our study can give hope to those patients that a better quality of life is on the horizon."
Dr. Derek Sant'Angelo, PhD, associate director of basic science, Robert Wood Johnson Medical School's Child Health Institute of New Jersey
Krzyzanowska, A.K., et al. (2022) Zbtb20 identifies and controls a thymus-derived population of regulatory T cells that play a role in intestinal homeostasis. Science Immunology. doi.org/10.1126/sciimmunol.abf3717.