'Invisible' inflammation in rare bowel disease may explain heightened colon cancer risk
New research from the Garvan Institute of Medical Research has revealed for the first time that two closely related bowel diseases, currently treated in the same way, are fundamentally different. The findings help explain why one carries a much higher risk of colon cancer—and point to the need for different approaches to treatment.
A groundbreaking study from the Garvan Institute of Medical Research has unveiled that two closely related bowel diseases, previously treated alike, possess distinct characteristics. This breakthrough sheds light on why one of the conditions carries a significantly higher risk of colon cancer and suggests tailored treatment approaches.
Primary sclerosing cholangitis (PSC) is a chronic liver ailment affecting approximately 1,000 Australians, which obstructs bile ducts and induces liver scarring. Around 70% of PSC patients also suffer from an inflammatory bowel disease (IBD) resembling ulcerative colitis. Despite shared similarities between these conditions, individuals with PSC endure milder flare-ups but are three times more susceptible to colorectal cancer.
Researchers from Garvan utilized advanced techniques to investigate colon biopsies from patients with each condition alongside healthy volunteers. Their findings revealed that PSC-associated IBD patients exhibited a unique microbiome and heightened immune activity even without typical inflammation or flare-ups. Dr. Kylie James, the study's lead author, posits that these revelations pave the way for more targeted PSC treatments potentially lowering colorectal cancer risk.
Conventional methods like colonoscopy and biopsy have often overlooked a specific type of immune cell, the cytotoxic immune cell, which was found in unexpected concentrations within the colon tissue of PSC patients. This hidden inflammation in otherwise seemingly healthy tissue may be the driving force behind the increased colorectal cancer risk.
During active flare-ups, both PSC-associated IBD and ulcerative colitis patients showed an accumulation of mast cells, immune cells involved in inflammation and allergic responses. These mast cells, fragile and typically destroyed during biopsy freezing, were successfully preserved and analyzed by the researchers, hinting at their potential role in cancer development during active inflammation.
Identifying these cellular features in the future could lead to personalized treatments based on the underlying biology of each condition rather than shared symptoms alone.
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