William Katkov, MD, a gastroenterologist with Saint John's Health Center in Santa Monica, Calif., answers questions about a recent research breakthrough regarding intestinal stem cell growth as a possible treatment for ulcerative colitis and Crohn's disease. A group of researchers from the Massachusetts Institute of Technology, Brigham and Women's Hospital, Harvard Medical School, Harvard Stem Cell Institute and Hubrecht Institute for Developmental Biology and Stem Cell Research in the Netherlands recently published a study in the journal Nature Methods.
The researchers have discovered a way to grow intestinal stem cells and direct the cells' development into different types of mature intestinal cells. William Katkov, MD, a board-certified gastroenterologist with Saint John's Health Center in Santa Monica, Calif., explains what these findings mean for the field of gastroenterology and the future of irritable bowel disease treatment.
Question: What do the results of this study mean for the field of GI?
Dr. William Katkov: This is the perfect marriage of very advanced basic science and clinical medicine. These advances may have a variety of applications for common GI clinical problems, such as ulcerative colitis and Crohn's disease, that affect many patients.
These researchers have found a way to grow large numbers, limitless really, of pure intestinal stem cells in a laboratory setting. It has also been shown that these cells can be controlled and differentiated into different types of specialized mature intestinal cells. These two developments together have tremendous potential for the treatment of chronic conditions.
Theoretically, one could develop a new and healthy intestine at some point in the future. Patients with severe disease could be provided a new, healthy and functioning intestinal tract. In addition, there may be other forms of cell therapy that can treat diseases without an entire transplantation.
Q: What other possible applications does this discovery have?
WK: Other consequences of this research that are very promising include the development of new therapies based on specific diagnoses. With specific cell types in the laboratory, one can carry out drug testing to look for novel and effective therapies. This is really the kind of advance that fulfills the promise of stem cell research.
Q: What needs to be done before this research can become an applicable treatment for IBD patients?
WK: There is often a lot of work that needs to be done between this kind of lab breakthrough and real applications to humans. There are experimental animal models, where new populations of intestinal cells have been shown to make sick animals healthy. The actual application to humans may not be right around the corner, but the next step is developing additional robust animal models to demonstrate efficacy and safety.
Q: Do you foresee any obstacles along the road to human treatment?
WK: By its very nature science is a story of unanticipated consequences. Dealing with biologic tissue and questions of immune tolerance and rejection are always delicate issues. Many of our questions will be answered as we go forward. We still have a lot of learning to do as research progresses.
Q: Is it possible that stem cells will replace any current treatments for IBD?
WK: From a long-term point of view, it may ultimately do that. At the very least, it is going to provide an entirely new avenue to explore treatments for these diseases. Some basic treatments have tremendous staying power. There is the traditional role of corticosteroids in the treatment of inflammatory bowel disease and the longstanding use of ASA compounds (i.e. mesalamine) in these chronic conditions. During the past 10 to 15 years, we have also taken exciting strides forward in the field of biologics, antibodies directed against proteins that mediate inflammation.
The idea of being able to provide populations of healthy intestinal cells to someone with a chronic disease is very exciting. While this may not eliminate other therapies, it might eventually become the definitive treatment.
More Articles on Gastroenterology:
16 Statistics on Irritable Bowel Disease Care
Top 10 Issues in Gastroenterology for 2013
AGA Launches New Guidelines for Crohn's Disease