Crohn’s disease is a chronic inflammatory bowel disease that can affect any segment in the digestive tract, from the esophagus to the anus. Although it affects millions of people worldwide, the exact cause is not clearly understood and there is no curative treatment. Many theories exist that try to explain the pathophysiology of the disease, however, none exist that can explain the entire disease process.
Correlation of a fungus with Crohn’s disease
A new theory regarding Crohn’s disease correlates a fungus causing dandruff to bowel disease. The fungus, Malassezia yeasts has been linked to dermatological conditions. It is predominantly found in people with oily skin and dandruff. According to a new study, this fungus not only resides in the skin and hair follicles, but it also sets camp in the gut.
Although the fungus causes little to no symptoms in the general population, it worsens the symptoms in people with inflammatory bowel disorders such as Crohn’s disease. The fungus seems to result in adverse effects in people with a specific genetic composition.
This discovery has led researchers to believe that removing this particular fungus from the gut flora could significantly improve the symptoms in people with Crohn’s disease.
Co-author of the study Dr. David Underhill, of Cedars-Sinai Hospital in Los Angeles, said: ‘We were surprised to find that Malassezia restricta was more common on intestinal tissue surfaces in Crohn’s disease patients than in healthy people. Further, the presence of Malassezia was linked to a common variation in a gene known to be important for immunity to fungi – a genetic signature more common in patients with
Crohn’s disease than the healthy population.’
Inflammatory Bowel Disease is believed to be a consequence of altered immune response to healthy gut microorganisms. Many studies focus on the elimination or alteration of these gut bacteria, the new study has analyzed the role of the fungus on the disease presentation.
According to Study co-author Dr. Jose Limon, a Cedars-Sinai research team member, alteration in the constitution of the normal healthy gut bacteria by fungi leads to an exacerbated immune response to the fungi. The immune response results in worsening of the IBD symptoms in patients.
This discovery was initially made in the gut microbiome of mice, which led to further research. Upon further experiments, increased immunity against the fungi helped in controlling bowel inflammation.
While comparing the gut flora between healthy individuals and Crohn’s disease patients, the gut flora in people with Crohn’s disease was found to be composed of several mucosa-associated fungi. M. restriction was found to be particularly elevated in people with Crohn’s disease-carrying the genetic variation known as the IBD CARD9 risk allele.
The genetic variant resulted in the enhancement of the ability of human immune cells to produce inflammatory cytokines in response to the presence of abnormal gut fungi. The researchers aim to study the benefits of complete eradication of the fungi from the gut microbiome in improving the symptoms of patients with Crohn’s disease.
Based on the study, it may be appropriate to use anti-fungal medications such as the widely available drug Fluconazole to relieve the uncomfortable symptoms of Chron’s disease. However, it is not recommended to use this medicine in people with other comorbid disorders such as liver cirrhosis. Additionally, there are reports of growing resistance to antifungals, hence reckless use of antifungals without a doctor’s prescription is also not advised.