Understanding how the immune system affects the development of perianal fistulas

Current treatments for perianal Crohn's Disease often fail to heal fistulas. Because of this, there’s a need to better understand the biology of perianal Crohn's Disease, particularly the link between inflammation and tissue healing, so we can develop better treatments for this group of patients.

Mr Phil Tozer, St. Mark's Hospital

What is this research looking at? 

Fistulas are a common aspect of perianal Crohn’s Disease, which affects about 1 in 3 people with Crohn’s. A perianal fistula is a small tunnel that develops between your bowel and the skin near your anus. They can leak poo, blood and pus, and can be very painful. They can have a huge impact on quality of life. As well as your physical health, they can affect your mental health, self-esteem and personal relationships. Perianal fistulas are also difficult to treat. A better understanding of the biology involved would allow us to develop better treatments.

The researchers are planning to explore how parts of the immune system affect the tissues around fistulas and how they develop. A protein called interleukin-22 (IL22) causes inflammation as part of the immune response. Previous research suggests that IL22 may play an important role in the development of fistulas. The researchers will collect samples from patients with perianal Crohn’s Disease. They will use these to study how IL22 affects the cells involved in fistula development.

They also plan to use the cells from these samples to create an interactive fistula model. This will be a valuable tool in helping them to study fistulas. It will also be helpful to future researchers studying perianal Crohn’s.

What do researchers think this could mean for people with IBD?  

The researchers hope that this research will help us understand how fistulas develop. Knowing more about this process will allow us to develop new medicines and treatments. More targeted medicines and treatments will be able to better support fistula healing.

The interactive fistula-specific model they plan to develop will enable future research in this area. It could also provide a way to help test future medicines and treatments targeted at fistulas.

Who is leading this research: Mr Phil Tozer, St Mark's Hospital

Our Funding: £54,143

Duration: 36 months

Official title of application: Probing the Role of Interleukin-22 Mediated Dysregulation of the Extracellular Matrix in Fistulising Crohn’s Disease


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