- Diseases, Disorders & Conditions
Simply Crohn's Disease?
The Perfect Storm-Crohn's Simplified
What is really going on with Crohn's disease?
We can look at all of the medicals terms, symptoms,and studies. But lets take a close look at the mechanism by which people are suffering from this horrible disease. I will attempt to take a path around a lot of scientific jargon. If it is necessary to use, say the name of a molecule or cell type, I will at least try to define it well enough that the reader can at least visualize it to some degree. After all, we are here to understand what is happening inside the body, not show off our vocabulary, right?
One of the major players in the genesis of inflammation, especially in Crohn's disease is Tumor Necrotizing Factor-alpha. Ok, a big word for a chemical in the body which simply causes a tumor to die. We will just call it TNF-a and will think of it as simply the tumor killing chemical. TNF- can actually do a lot of things such as induce fever, cause inflammation, keep tumors from growing and even keep viruses from reproducing. In the right levels, TNF-a is a very useful tool in keeping the body safe from infections and tumors. But if it is not regulated, or something causes the body to produce too much we call this dysregulation. Simply put, the TNF-a is simply not being regulated. Unregulated and excessive TNF-a has been indicated as a factor in several human diseases such as depression, Alzhiemer's, Crohn's /IBD, and even cancer.
TNF is released in large amounts in the presence of lipopolysaccharides (LPS). Again, a big word with a simple meaning. In short, it is simply a toxic substance which is present in the cell envelope (skin) of certain bacteria. It is this LPS which gives these bacteria a resistance to antibodies. When these bacteria come in contact with certain cells in the intestines, large amounts of TNF are released in defense of the intestinal cells.
Ok, so far , we have bacteria that are resistant to antibodies coming in contact with a cell that releases TNF-a in an effort to protect itself. Simple so far.
The problem gets a little more complex when we realize that the bacteria can be E. Coli and P. Auregenosa. It really isn't important to remember their names, just remember that they are difficult bacteria to control and that they can cause a lot of damage because they produce huge amounts of LPS. For the sake of simplicity you can think of them as bacterias X and Y. In fact, there are a wide variety of bacteria that can infect the gut and trigger TNF-a to be released. Candida Albicans, a yeast, also comes into the picture. Combined with bacterias X and Y, it will form “biomats” in the mucosa (slimy coating) of the intestines. You can think of the biomats as super microscopic coral reefs which are a mixture of bacteria and Candida. This is a great advantage for the Candida because the bacteria which produce LPS (poison) act to protect the yeast from antifungal medicines. The yeast, in turn, provides cover for the bacteria to go about their business. If you have ever been to a stagnant pool and saw a layer of “pond scum”, you can easily envision this in the intestine. Pond scum is, in all actuality, a biomat made up of algea and bacteria which covers the floor of the pond.
Now we have a gang of microorganism working in concert against the intestinal wall, invading the mucosa. Eventually, the biofilm or biomat reaches a dendridic cell in the intestinal wall. A dendridic cell is simply a tree like cell which produces not only TNF-a, but other immune helper chemicals like Interleukin-1(IL-1) and interleukin-6 (IL-6).
Lets take a brief look at interleukins.
Interleukins are actually a large family of chemicals produced by the body which carry out immune functions. We will only concern ourselves with 1 and 6 for now.
IL-1 can also trigger the release of TNF-a, and is produced in large quantity in dendridic cells an epithelial cells. When the biomat comes in contact with the dendridic (tree like) cell, IL-1 is released as a defense mechanism by the cell. It acts as a signal and more TNF-a is produced. This helper chemical is usually in elevated quantities in the case of Crohn's disease.
IL-6 can regulate the production of TNF-a and IL-1, but it can also increase it as well, especially in the case of depression and cancer.
Ok, now we have an intestine with a biofilm of bacteria and yeast growing in the mucous of the intestines containing huge amounts of LPS. The LPS triggers the release of TNF-a. Below the biofilm are tree like cells called dendridic cells. When challenged by the harmful bacteria, the dendridic cell produces IL-1 and IL-6. This triggers more TNF-a to be released. The result is inflammation. Prolonged inflammation as a result of this biochemical war being waged at the site eventually develops an ulcer. Remember, TNF-a is designed to kill tumors.
Now the defense of the intestine has been breached. Pseudomonas and E. Coli are free to attack the other cells in the area of the ulcer and beyond. This is where there is the possibility of an abscess and eventually a fistula.
Currently, medical science uses TNF-a “inhibitors” such as infliximab (Remicade), adalimumab (Humira) certolizumab pegol (Cimzia) or a protein which circulates through the blood and decreases the effect of TNF-a such as etanercept (Enbrel).
The main problem with these all are that they not only do not address the problem of what really initiates the disease (bacteria and fungus), but they leave the patient at the mercy of a pharmaceutical company for the rest of their life.
The TNF-a can tell a cell to produce an chemical called cyclooxygenase (COX). There are two forms of COX: COX-1 and COX-2. This is a very important piece of information when one considers that COX-1 can be produced in almost all human tissues, but COX-2 is produced in greater quantity in the gut of Crohn's patients , especially in their intestinal mucous. This is significant because COX-2 is the COX that produces inflammation and pain.
So, here is what we have to this point. A mat of bacteria and fungus growing in the intestinals mucous, producing a concentration of LPS (poison). The body is responding by producing TNF-a, IL-1, and IL-6, all of which can cause inflammation. The cells in Crohn's patients make the problem worse by producing COX-2, which also causes inflammation. What you have now is the perfect storm, so to speak. The inflammed area becomes an immunological free for all. The body responds to the confusion as if it were fighting cancer, infections, and cell anomolies.
No discussion of the Crohn's problem can be complete without the discussion of Interferon-gamma (INF-y). INF-y is an immune factor (chemical) produced by immune cells when there is a threat. Experiments have shown that there is a marked difference between the production of INF-y in healthy human intestinal tissues and those of Crohn's sufferers. In normal gut cells, INF-y was at its highest level 72 hours after researchers exposed the cells to a threat. In Crohn's patients, however, INF-y spiked only 24 hours after the cells were threatened. The other differences was that Crohn's patients had a higher level of INF-y prior to the experimentation than the healthy patients did. What this means is that something was keeping the Crohn's patients cells in a threatened state, for example LPS.
I do not wish to discount the genetic aspect of the disease, after all, the reactions described above are all dependent upon DNA and RNA.
The magic bullet that would combat the perfect storm would ideally:
a) kill bacteria that produce LPS such as P.Auregenosa and E.Coli
b) kill yeast and other fungus like C. Albicans
(Thereby eliminating the biomat in the intestinal mucosa.)
c) Reduce the production of TNF-a induced by LPS
d) Block the production of COX-2 induced by LPS
e) Limit the production of IL-1 and IL-6 induced by LPS
f) Stay in the intestine and not be absorbed in great quantity into the blood stream
g) Must not harm the healthy fauna of the intestine.
The magic bullet exists in the form of chrysophenol, a chemical produced throughout the vegetable kingdom. Unfortunately, chrysophanol costs about nine hundred dollars per gram. A special extract of the coccoloba leaf has been used as an intestinal cleanser for only five days out of a month and has relieved the suffering of the illness. Coccoloba contains chrysophanol as well as other members of its family (called anthraquinones).
The beauty of this molecule is that it kills P. Auregemonas, E. Coli, C. Albercans, and when ingested by beneficial fauna of the intestine, it gets converted into emodin , a laxative. This helps to push the unwanted fauna and dying biomat out of the body. Furthermore, it regulates the production of COX-2,IL-1, IL-6, and stays in the intestine.
In short, there is a perfect solution to the perfect storm. It is inexpensive, does not have to be used daily, no prescription is needed. Suffering from Crohn's can become a thing of the past, giving these people a bright and productive future.