Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract causing abdominal pain, diarrhea, gastrointestinal bleeding and weight loss. Treatments for Crohn's disease are designed to reduce the inflammation but may be associated with rare but serious side effects, including infections and lymphoma. Research suggests that endorphins and enkephalins, part of the opioid system, have a role in the development or continuation of inflammation.
Naltrexone is a drug used to help recovering alcoholics and drug users stay clean. It inhibits the body's opioid system that regulates pain and is involved in cell growth, repair and inflammation. Naltrexone binds to a protein receptor that blocks the effects of opioids, including the body's own enkephalins and endorphins, substances that reduce pain and produce a feeling of wellbeing.
"Although the cause of Crohn's disease is unknown, research suggests it involves a complex interplay of environmental, genetic, microbial, immune and nonimmune factors," said Jill P. Smith, M.D., professor of medicine. "We hypothesize that the opioid system is involved in inflammatory bowel disease and that interfering with an opioid receptor will lead to the reversal of the inflammation."
Researchers studied 40 patients with active Crohn's disease. Patients received either naltrexone or a placebo for 12 weeks. All patients then continued on naltrexone for an additional 12 weeks. This was a double-blind study with neither the patient or healthcare provider knowing which treatment was being received.
Eighty-eight percent of those treated with naltrexone had at least a 70-point decline in Crohn's Disease Activity Index scores compared to 40 percent of placebo-treated patients. CDAI is a point system used to quantify symptoms in Crohn's patients. Researchers noted no statistical difference at four or eight weeks of treatment, suggesting a response requires at least 12 weeks of treatment. Results were published in the journal Digestive Diseases and Sciences.
Gastrointestinal inflammation was evaluated by appearance of the intestine on colonoscopy and scores from biopsy specimens. After 12 weeks, researchers noted no change in those taking a placebo. However, 78 percent of those on naltrexone experienced healing in the lining of the intestine.
For those patients who received a placebo for 12 weeks and then were placed on naltrexone for the following 12 weeks, 70 percent experienced at least a 70-point decline in the CDAI score and healing of the colon as seen on colonoscopy. Patients who continued use of naltrexone for an additional 12 weeks (24 total weeks) had a further 75-point decline in CDAI scores, leading to remission (score of less than 150) in 50 percent of the patients.
"We report that naltrexone improves clinical and inflammatory activity of subjects with moderate to severe Crohn's disease compared to placebo-treated controls," Smith said.
The researchers are planning clinical trials to look at use of naltrexone in children with Crohn's disease and have secured orphan drug status from the Food and Drug Administration for the use of naltrexone in children with Crohn's disease. Smith and Zagon hold a patent for the use of naltrexone in inflammatory bowel disease -- Crohn's disease and ulcerative colitis.
The National Institutes of Health's Broad Medical Research Program funded this project.
Other researchers on the project are Ian Zagon, Ph.D., Department of Neural and Behavioral Sciences; Sandra I. Bingaman, R.N., Aparna Mukherjee, M.D., and Christopher O. McGovern, B.S., Department of Medicine; Francesco Ruggiero, M.D., Department of Pathology; and David Mauger, Ph.D., Department of Public Health Sciences.
Matthew Solovey | EurekAlert!
Electrical 'switch' in brain's capillary network monitors activity and controls blood flow
27.03.2017 | Larner College of Medicine at the University of Vermont
Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
27.03.2017 | Earth Sciences
27.03.2017 | Life Sciences
27.03.2017 | Life Sciences