Uncovering the Root Causes

The number of people diagnosed with Crohn’s disease is increasing globally, which has escalated the urgency of our task. Our goal is to identify the root causes of the disease, including the environmental risk factors that can trigger it or cause flares. We also want to identify the biological markers that can predict a patient’s disease course and their response to treatment so that a personal prevention strategy can be implemented.

The causes of Crohn’s disease remain unknown, and there is yet no cure. What is known is that it is a complex, multifactorial disease involving genetic predisposition, environmental triggers, and abnormalities in the microbiome and immune system.

Studying Geographical Trends

Crohn’s disease poses a heavy and increasing burden on societies and healthcare economies, as incidence remains high in the Western world and is rising in newly industrialized nations. Intervening effectively as early as possible in the disease course seems to offer the best prognosis, yet the actual diagnosis is challenging due to a lack of non-invasive diagnostic biomarkers. Further, there are currently no devices or tools available for monitoring Crohn’s disease, and patients are commonly misdiagnosed.

Notably, the increase in incidence is particularly rapid in those regions of Africa, Asia, and South America that are also undergoing shifts from a traditional to a more Western diet and lifestyle, suggesting that the environment affects disease risk. Environmental factors – such as diet, antibiotic use, or infections – can increase risk on an individual level, whereas societal trends like urbanization can alter risk on a population level.

We support international research initiatives that will improve our understanding of the environmental component of Crohn’s disease to uncover further its root causes and to identify how the disease develops. Studying what factors are driving the global increase in Crohn’s disease could provide important new insights for prevention.

Understanding the Role of Diet

Among the known environmental risk factors for Crohn’s disease, diet is one that impacts the composition and function of the trillions of microorganisms that inhabit the gut, collectively known as the microbiome. We fund research to accelerate our understanding of the role of the gut microbiota and the diet-host-microbiota interactions in Crohn’s disease. Our goal is to identify dietary interventions that can improve the course of the disease, which could have both immediate and lasting benefits for disease management.

An important step in ultimately preventing Crohn’s disease will be the accurate identification of individuals who are at future risk; that is, to prevent, we must first accurately predict. We want to predict the likelihood of someone ever developing it. We want to predict the time period in which clinically apparent disease will appear. And we want to predict the development of complications. Preventing any disease is difficult, but Helmsley is heavily invested in supporting the research and development of preventive strategies for Crohn’s disease. The challenge is significant, but the potential reward is great. By understanding how the disease develops and by developing safe and effective strategies for intervention, we can focus on efforts to prevent onset, recurrence, or progression, and reduce complications of the disease.