Medication for Crohn’s disease also affects pain perception in the brain

Around 300,000 people in Germany suffer from Crohn’s disease. One of the main symptoms of this inflammatory bowel disease is severe abdominal pain. It is often treated with special antibodies which block a messenger substance that is involved in the disease. FAU researchers have now demonstrated for the first time that these antibodies not only alleviate inflammation but also affect how pain is perceived in the brain.

Crohn’s disease is a chronic inflammatory bowel disease in which patients suffer from symptoms such as painful stomach cramps, making it difficult to lead a normal life. An important factor in the development of the disease is a messenger substance in the immune system called tumour necrosis factor (TNF). In recent years, specially designed antibodies, known as TNF inhibitors, have proven to be effective at treating Crohn’s disease. These inhibitors block TNF, alleviating inflammation. Until now, researchers were puzzled by the fact that patients’ severe pain disappears very quickly after starting treatment although the inflammation itself does not subside for several weeks. The quick alleviation of pain therefore cannot be due to the healing of the intestinal mucosa.

Investigating the relationship between the immune system and the brain

A team led by FAU researchers PD Dr. Andreas Hess, Chair of Pharmacology and Toxicology, and Prof. Dr. Raja Atreya, Chair of Internal Medicine I, has now investigated this phenomenon using non-invasive functional magnetic resonance imaging in collaboration with Prof. Dr. Arnd Dörfler, Neuroradiology. Using this imaging technique they were able to show that TNF inhibitors lowered the pain perception in the brains of Crohn’s disease patients after just one day, despite the fact that the actual inflammation only improved after ten to twelve weeks.

These findings led the researchers to conclude that the tumour necrosis factor not only plays a key role in the development of Crohn’s disease but also influences pain perception in the brain. ‘The results of the study expand our knowledge of the mechanisms of diseases of the immune system such as Crohn’s disease, as well as the relationship between the immune system and the brain,’ Dr. Hess explains. ‘New forms of treatment for Crohn’s disease could be developed based on the findings of this study,’ Prof. Atreya says. The researchers now aim to investigate to what extent early alleviation of pain perception in the brain can be used as a predictor of treatment response to anti-TNF therapy for patients with Crohn’s disease.

They recently published their findings in the journal Gastroenterology:

http://dx.doi.org/10.1053/j.gastro.2015.05.063

Further information:

PD Dr. Andreas Hess
Phone: +49 9131 8522003
andreas.hess@fau.de