Research by NZ microbiologist John Aitken has recorded a major advance in the treatment of Crohn’s disease, which affects 20,000 New Zealanders!
Christchurch gastroenterologist Professor Richard Gearry, who has worked with Aitken on previous studies, says scientists have struggled to grow the MAP-type bacteria and “nobody has had the same sort of success . . . as John”.
“If you can grow it, you can start to explore causation a lot more. Not only that, but that work will translate to Johne’s disease in livestock which is a big problem in NZ.
“People internationally are very interested in that. All of sudden you can get underneath the clinical observations and try and understand those mechanisms as to what is going on.”
Aitken became interested in Crohn’s as a 23-year-old when he was told he had it. He spent the next three years with an image of his colon snapping like a carrot.
It turned out he did not have Crohn’s, but his brush with the disease sharpened his interest.
By 2010, he was able to grow the bacteria and Crohn’s clinicians and researchers were starting to take notice.
A year later, Aitken and others set up a medical laboratory under the banner of Otakaro Pathways Ltd in the old Princess Margaret Hospital mortuary. Funding came from various sources including Callaghan Innovation.
Canterbury’s earthquakes intervened, but Aitken is pushing ahead with his research with renewed vigour and setting up a new laboratory in the Templeton Industrial park.
One of the shareholders is Professor Tom Borody, who runs the Centre for Digestive Diseases in Sydney. He is a controversial figure in his field, but since he invented using antibiotic therapy against the bug that can cause stomach ulcers, he is not taken lightly.
Borody doesn’t need more testing to be convinced Crohn’s is bacterial in origin. He is well known in Australia as a gastroenterologist prepared to treat Crohn’s with a cocktail of antibiotics which Aitken says are achieving 80 to 90 per cent remission rates.
While patients are queuing up to see Borody, the medical world is not exactly beating a path to his door.
“It’s very difficult for experts to prove themselves wrong,” says Aitken, who doesn’t want to be pigeonholed as a bacteria advocate, although it’s clear where his research places him.
He avoids calling the organism he has grown and made visible MAP.
“What we are trying to do is have a test out there that can tell whether therapy against the mycobacterium is working.”
If researchers find out that mycobacteria cause Crohn’s and discover how the mechanism works, the key to curing or treating other diseases like multiple sclerosis might be next.
For the moment, mainstream gastroenterologists like Gearry will not prescribe the cocktail favoured by Borody to Crohn’s patients even if they want them.
He describes the immune system versus bacteria Crohn’s debate as “incredibly polarising”.
“A lot of groups around the world are very strong in using this anti-MAP therapy. They all zealously believe MAP is the cause . . . but the concern is maybe they can’t afford to see [their hypothesis] fail and there are financial interests in it as well.”
Gearry says the best test of anti-MAP therapy so far was a randomised control trial in Australia involving about 200 patients who were given the three antibiotics Borody and others claimed were the key to treating Crohn’s.
Those running the trial, the methodology of which was later criticised, concluded the anti-MAP therapy was no more effective than a placebo.
The results did not discourage large Israeli pharmaceutical company Redhill from funding another randomised control study which got under way this year. Redhill developed a pill which combines the three antibiotics – Clarithromycin, Rifabutin and Clofazimine – used by Borody.
Gearry is supervising the trial in Canterbury and so far has two patients taking part.
“I have no opinion on it. What I have been really worried about is the science behind what has gone on with the clinical aspects of this. It hasn’t been rigorous and it’s been led by people other reasons for it to succeed.”
The results of the trial are keenly awaited internationally.
Meanwhile, other Crohn’s research groups around the world are making strides into aspects of Crohn’s. Aitken, for instance, is working with a group in Bulgaria. The race is on.
Aitken hasn’t published his work for fear of it being pinched. He not quite ready to tell the world. He certainly doesn’t need more money.
“Instead of going in with circumstantial evidence, you are much better going in with total forensic evidence.”
Aitken comes back frequently to the patients and their mothers.
“The mothers of the children are just unbelievable. I’ve never seen anything like it. It’s like they sense there is something out there they must reach it whatever it takes.”
They send him cards, drawings and letters of thanks.
“This article taken from the magazine stuff.co.nz”