Research links gut fungi to intestinal inflammation in Crohn’s disease
Research links gut fungi to intestinal inflammation in Crohn’s disease
Results of a new study by researchers at Case Western Reserve University represent a step toward improving our understanding of Crohn’s disease and the factors that cause its intestinal inflammation.
Crohn’s disease is a type of inflammatory bowel disease that can lead to chronic inflammation of the entire digestive tract. Symptoms include diarrhea, pain and cramping, fatigue, weight loss and more. There is no cure for Crohn’s disease, but patients can alleviate symptoms with current treatment options.
New treatment options for Crohn’s disease patients may be on the horizon thanks to the research linking a common fungal pathogen to inflammatory bowel disease.
The study recently appeared in Cellular and Molecular Gastroenterology and Hepatology.
This new research from the Case Western Reserve School of Medicine focuses on the role of the fungus, Candida tropicalis (C. tropicalis), in triggering chronic inflammation within the gut microbiome. The gut microbiome is a complex ecosystem of fungus and bacteria found within the digestive tract.
Researchers introduced the fungus into animal models and induced colitis (inflammation of only the large intestine) through a chemical compound. The models infected with C. tropicalis showed severe inflammation and significant imbalance of the gut microbiome with changes in bacteria levels.
Researchers say the findings show that this imbalance of fungi and bacteria can create a predisposition to inflammatory bowel disease. Past studies have shown that people with Crohn’s disease have higher levels of C. tropicalis when compared to healthy individuals.
Understanding the impact of C. tropicalis on a person’s health will play a role in developing treatments for Crohn’s disease.
“Our findings provide a scientific rationale for eliminating C. tropicalis fungal infection of the gut,” said Fabio Cominelli, professor of medicine and pathology and associate dean for program development at the Case Western Reserve School of Medicine. “The next step in our research is to study other fungal organisms within the gut and then antifungal therapies in patients with this devastating condition. Remission is very difficult to obtain in Crohn’s disease patients.”
Original source here.
Coronavirus (COVID-19) Response
Updated January 2022
COVID-19 VACCINE INFORMATION
The Federal Government is rolling out COVID-19 Vaccine to the Australian population. You can learn more about timelines and eligibility on the Department of Health website.
LINK: Department of Health website.
NEW – OCTOBER 2021 – THIRD DOSE RECOMMENDATION
The Australian Technical Advisory Group on Immunisation (ATAGI) has recommended a third dose of COVID-19 vaccine in individuals who are severely immunocompromised. More details are provided on the Department of Health website and indicate that limited IBD treatments are eligible. International evidence continues to build and CCA anticipates further advice from GESA and ATAGI in the future. If you have any queries, we encourage you to have a discussion with your clinical team. Changes to your medications should always be discussed with you doctor.
The Australian Government Department of Health (DoH) and the Australian Technical Advisory Group on Immunisation (ATAGI) regularly provide updates regarding the vaccine safety and efficacy.
The Department has made a vaccine eligibility checker available.
Information on Phase 1B eligibility for vaccination was made available directly from the Department of Health on 17 March 2021 and is shown below. It is recommended that you check with your healthcare professional for the best advice relating to your condition.
PHASE 1B: UNDERLYING MEDICAL CONDITIONS
Chronic inflammatory conditions on medical treatments
Including: Systemic Lupus Erythematosus, Rheumatoid Arthritis, Crohn’s disease, ulcerative colitis, and similar who are being treated with Disease modifying anti-rheumatic drugs (DMARDs) or immune-suppressive or immunomodulatory therapies. Generally not inclusive of people living with osteoarthritis, fibromyalgia, myalgic encephalomyelitis/chronic fatigue syndrome or similar non-immunocompromising inflammatory conditions.
Proof of eligibility – underlying medical conditions
- For individuals attending their usual GP, the clinic’s records may be relied upon as evidence
- MyHealth Record
- A referral from GP or treating specialist
- Alternative medical records, including:
- a printout of your medical history as recorded in your clinical records;
- a printout of your chronic disease care plan; a discharge summary from a hospital or other medical facility; or
- a valid script or medication prescribed to treat one or more of the relevant medical conditions
- Where none of these are available, individuals may complete a Phase 1B Declaration Form
The Gastroenterological Society of Australia (GESA) has released information on COVID-19 vaccination for people with gastrointestinal conditions (including Crohn’s and colitis) or liver diseases on immunosuppressive therapy which comments on safety and effectiveness.
CCA will continue to communicate up-to-date information regarding vaccines, particularly any impacts relating to people living with IBD.
The respiratory illness COVID-19 (known generally as Coronavirus) is a virus that is the subject of a health alert in Australia, and has been declared a pandemic by the World Health Organisation.
Symptoms of COVID-19 can range from mild illness to pneumonia. Some people will recover easily, and others may get very sick very quickly. People with coronavirus may experience:
- flu-like symptoms such as coughing, sore throat and fatigue
- shortness of breath
The Australian Government Department of Health provide a daily update on medical advice about COVID-19.
GOVERNMENT SUPPORT INITIATIVES
The Federal Government has announced a range of initiatives to support Australians during the COVID-19 pandemic including funding to allow doctors, nurses and mental health professionals to deliver services via telehealth to people with chronic diseases or who are immunocompromised.
TELEHEALTH UPDATE – 10 JULY 2020
In a major boost for primary health care, the Australian Government is further strengthening telehealth arrangements as recommended by the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) and other medical experts.
It is recommended to download the COVIDSafe App.
The Royal Australian College of General Practitioners has released a fact sheet regarding the COVIDSafe app.
WHAT DOES COVID-19 MEAN FOR PEOPLE WITH IBD?
ADVICE FROM GESA
The Gastroenterological Society of Australia (GESA) has provided information for people with gastrointestinal disorders. Click here to read the recommendations from GESA (published March 2020).
While immunosuppressed people are not at a greater risk of acquiring COVID-19 than the general population, it may have an impact on their ability to recover should they contract the virus.
Those who are on immunosuppressive medication [azathioprine, mercaptopurine, methotrexate, prednisolone, infliximab (Remicade, Inflectra), adalimumab (Humira), ustekinumab (Stelara), golimumab (Simponi), vedolizumab (Entyvio)] should make sure they follow all the measures to prevent person-to-person spread with:
- Social distancing (1.5m)
- Handwashing with soap and water, or alcohol based gels
- Avoidance of crowded areas
- Good basic hygiene- avoid touching your face and nose
If this is you, please also think about whether you can take additional measures to reduce contact with others, such as working from home where you can, or self-isolate in organisations that have large groups of people.
It is important to protect yourself against other common respiratory infections. Therefore, it is recommended that all patients with reduced immunity have the Influenza Vaccine (flu-shot) as soon as it is available.
There are no shortages of medication to treat IBD as a result of COVID-19 related demand at the moment. Some community pharmacies and hospitals are experiencing delays of a few days for delivery of some medications.
The government has restricted pharmacists to dispensing a one month supply for some medications, as a precautionary measure. This includes some pain relief and gastroenterological medications. For more information go to: https://www.tga.gov.au/media-release/covid-19-limits-dispensing-and-sales-pharmacies
People with IBD should be eligible for free delivery of medications once per month. For more information speak to your local pharmacy or visit: https://www.health.gov.au/resources/publications/covid-19-national-health-plan-home-medicines-services-information-for-consumers
IBD medicine restriction criteria lifted
PBS restriction criteria for some IBD medicines have been lifted to avoid medical appointments during COVID-19 pandemic. Prescribers can apply for an exemption for some medicines if a patient has had them prescribed before. Some biologic medicines used to treat IBD are included. For a full list of medicines and further details, visit: http://www.pbs.gov.au/info/news/2020/05/pharmaceutical-benefits-scheme-restriction-requirement
GESA has provided advice on safe return to school for children with IBD. The detailed reasoning and some useful FAQs are provided here.
GESA has also previously provided advice to gastroenterologists on IBD management in children and young people:
- Recognition that age is a major risk factor for COVID-19 outcomes, but to be cautious about this as new information is collected
- Postponement of all non-urgent endoscopy procedures and guidance on safe endoscopy practices for urgent cases
- Using temporary MBS funded telehealth consultations where appropriate
- The need for patients to continue treatment unless a change is agreed with their IBD team
MENTAL HEALTH SUPPORT
Beyond Blue have set up a resource page to help people manage their mental health during the COVID-19 pandemic. View their advice here.
The Australian Psychological Society has also provided tips on coping with COVID-19 related anxiety. Read those tips here.
Smoking can worsen IBD and according to the WHO it can increase your risk of COVID-19 infection and serious lung conditions such as pneumonia, see why here.
If you need support to stop smoking, visit QUIT.
COVID-19 WORLDWIDE DATABASE
A consortium of international IBD research organisations has established a worldwide database to rapidly define the impact of COVID-19 on patients with IBD and how factors such as age, comorbidities, and IBD treatments impact COVID-19 outcomes. GPs and gastroenterologists can add case reports to the database as soon as the diagnosis is made.
CCA encourages people with IBD who contract COVID-19 to discuss with their doctor inclusion of their case report on the COVID-IBD database.
As at 13 October 2021, only twenty COVID-19 cases have been reported in Australia among those living with a diagnosed IBD since the beginning of the pandemic. There have been 6,635 cases reported worldwide.
Brenner EJ, Ungaro RC, Colombel JF, Kappelman MD. SECURE-IBD Database Public Data Update. covidibd.org. Accessed on 14/07/20.
CCA SUPPORT GROUPS
Some of our support groups are still running, depending on location, while many are also meeting online. For the latest information please click here or call 1800 138 029.
As a result of COVID-19, some council areas around Austraila have closed various public toilet locations. Before commencing any necessary travel, we recommend contacting the local council in that area to check on open locations. The National Public Toilet Map can be found here.
TOILET PAPER SUPPLY
CCA understand that some of our members are experiencing difficulties in purchasing toilet paper. This can be a stressful predicament for someone living with IBD.
In March, we were pleased to see Woolworths take action to support people living with Crohn’s and Colitis who are taking immunosuppressive medication or are required to self isolate. For more information, visit this link.
A huge thank you to the team at Quilton who have generously donated 6,000 rolls of toilet paper to CCA to distribute to members who are most in need, as part of the Quilton 1 Million Rolls donation initiative.
Proudly supported by Roche Australia
For guidance regarding your IBD, Crohn’s & Colitis Australia continues to operate its support services:
- Crohn’s & Colitis Helpline: for individual help, information and guidance on Crohn’s disease or ulcerative colitis.
Call 1800 138 029 (option 1, then option 1).
- Crohn’s & Colitis NurseLine: To book an appointment to speak with a Registered Nurse with specialised knowledge of Crohn’s disease and ulcerative colitis (an IBD Nurse) who can help you with education, support and help you build your own personalised care plan.
Call 1800 138 029 (option 1, then option 2)
- iConnect: Trained support crew and registered IBD nurses can be reached online for a confidential conversation should you, a family member or friend, need support. Click here.
For advice specific to your condition, it is strongly recommended you speak with your treating specialist or GP.