There is a lack of knowledge about how the immune system works in intestinal diseases such as Crohn’s disease and ulcerative colitis in children. It’s also not clear how inflammatory bowel disease, IBD, differs between children and adults.
About 40 percent of patients — both children and adults — do not respond to available treatments. It is therefore important to identify biomarkers that can predict how treatments will work and also contribute to finding new treatment modalities.
To increase knowledge about IBD, a research team has mapped the immune system in the gut.
– We still don’t have a cure for inflammatory bowel diseases like Crohn’s disease or ulcerative colitis, only symptomatic treatment. IBD often begins in early adulthood, sometimes as early as childhood. This study comes from the clinical need to understand why disease occurs and what happens in the gut in IBD, says Jenny Magosberg, professor of tissue immunology at Karolinska Institutet.
Immune cells in the intestine were analyzed
The researchers studied the intestines of 25 children and eight adults with inflammatory bowel disease. Patients were compared with a control group.
The researchers used methods such as flow cytometry and single cell technology. These are two relatively new technologies that allow the analysis of immune cells from the colon.
The finding shows that more cells that can contribute to inflammation appear to be present in children with IBD. At the same time, there are fewer cells that protect the intestines.
Inflammation appears to be related not only to the aggressive cells that drive it, but also to the loss of function of cells that help maintain a healthy gut. Treatments available today are only intended to suppress inflammation, says Jenny Mjösberg, but they can be just as important to strengthening the part that protects tissues.
More on the cell findings in the study
The researchers saw that proinflammatory cell types, such as innate lymphocyte type 1 (ILC1) and cytotoxic cells such as T cells and natural killer cells, occurred to a higher degree in children’s intestinal inflammation.
A specific subtype of tissue-protective lymphocytes, so-called innate lymphocyte type 3 (ILC3) and tissue-resistant T cells, were present to a lesser extent in the intestinal mucosa of children with IBD.
We hope for individual treatments
The researchers hope that the results of the study will become part of the puzzle for developing new treatments.
– We still have a rather poor knowledge of biological medicines and why they work or not. Then vital signs are very important. In the long term, we hope for more individually customized treatments, and this study is a step in that direction, says researcher Helena Rolandsdotter at the Karolinska Institutet.
The research is a collaboration between researchers and clinicians at Karolinska Institutet, Sachska Hospital for Children and Young People and Karolinska University Hospital.
Scientific study:
The monocyte transcriptional landscape of innate and adaptive lymphocytes in pediatric colitisMedicine, Cell Reports.
communication:
Jenny Mjosberg, Professor of Tissue Immunology at the Department of Medicine, Karolinska Institutet, [email protected]
Tel: 070-547 29 56
Helena Rolandsdotter, Senior Physician at Sachsska Children’s Hospital and researcher in the Department of Clinical Research and Education, Södersjukhuset, at Karolinska Institutet, [email protected]
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