SEK 9 M / 3 YEARS
THE AIM IS TO GIVE THOSE SUFFERING FROM IBS BETTER TREATMENT Irritable bowel syndrome (IBS) is a gastrointestinal disorder that plagues nearly a tenth of the population in the western world. Although it does not shorten life, it has a major impact on people’s lives and health. Magnus Simrén wants to take a holistic approach and develop better treatment.
Irritable bowel syndrome (IBS) is estimated to a ffect around one in ten people in the western world. Magnus Simrén, a researcher at the University of Gothenburg and doctor at Sahlgrenska University Hospital, found himself devoting his medical career to gastroentero logy from early on. “In this area IBS is a fascinating condition, because the interaction between the brain and the gut is a key aspect of the symptoms,” he says. Although IBS is common, it has been unclear why the condition arises. “We now believe that it is partly to do with what happens in the microbiome in the gut – an interaction between food, gut bacteria and the immune system,” says Magnus Simrén. In one in five people who get IBS, the condition arises after a gastrointestinal infection. “Patients might say ‘I had a stomach upset in Thailand and I’ve had stomach problems ever since’,” he says. In February this year a scientific study was published in Nature in which Belgian researchers describe a possible mechanism. In tests involving mice they introduced a gastrointestinal infection and at the same time gave the mice a certain type of food. After the mice had recovered from the infection, they were given the same food again and experienced something that resembled an allergic reaction along with pain sensitivity in the gut. “The interpretation is that the immune system is activated incorrectly when the infection takes place. Normally immune cells in the gut do not react to food, which is called oral tolerance. When they do, you get an overreaction to the foods,” says Magnus Simrén.
Last year his team was able to show that 30 p ercent of patients with IBS were infected with a s pecific bacterium called Brachyspira. In contrast, this bacterium was not found in people without IBS, as they published in Gut. “Patients also had an allergy-like activation of the gut’s immune system. Whether that is a reaction to the bacterium itself or to food, for example, is still uncertain and is something that needs to be studied further,” he says. They will now do this in the project Irritable bowel syndrome (IBS): A disorder caused by micro bes, leading to loss of tolerance to d ietary antigens? One part of this involves using allergy tests in the gut to investigate which foods infected individuals are sensitive to. “We’ll be using a technique similar to the prick test done on the skin for allergy testing. The difference is that we’ll be doing the test in the gut and testing locally there for substances such as soy, egg, gluten and other foods,” he says. They will also continue to map the Brachyspirainfected patients – for example as regards their symptom profile, other gut flora composition and function, and the functioning of the immune cells in the gut. In the third part of the project the researchers will attempt to restore the patients’ gut function in various trials. “Here we want to try out many different approaches. Is excluding certain foods effective? Can the Brachyspira infection be eradicated using bespoke antibiotic treatment? Or how about if we use certain drugs to block nerve function in the gut?” For this ambitious project to achieve its objective,
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