Cause of pain in children with IBD

What the research looked at? 

Gut pain is a major problem for children with Crohn’s or Colitis and can be difficult to treat.  But what causes this pain is not well understood, and many children experience pain even when they are in remission. This suggests that the causes of pain and gut inflammation are different.  

Research has already shown that tissue samples from children with Crohn’s or Colitis can stimulate pain sensing nerves. This study looked for the substances (mediators) in the gut tissue which leads to this activation of pain signals. 

They compared tissue samples from people:  

• newly diagnosed with Crohn’s Disease  
• with Crohn’s Disease that had not responded to treatment 
• with a healthy gut. 

Several mediators were found to be involved in the cause of gut pain. This included specific enzymes known as MMPs (matrix metalloproteinases), activation of CXCR3 receptors for cytokines (chemicals produced in the inflammatory process) and mediators produced by neutrophils (a type of white blood cell). They also found a signal that draws T cells (a different type of white cell) into the gut may be a possible cause of pain. 

The researchers were able to identify the causes of inflammation successfully treated by current drugs and those which are not. 

Conclusion 

Signals relating to the function of T cells are present in inflammation that does not respond well to current drug therapies. This suggests that targeting T cell function may improve disease treatment in the future.   

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

This study has further increased our understanding of pain in children with Crohn’s and Colitis. Researchers now plan to build on these findings in further studies. They hope this will lead to the development of new therapies to control gut pain in children. 

Who is leading this research? Professor Nick Croft, Barts and the London Hospital/Queen Mary University of London 
Project cost: £10,000 (jointly funded by BSPGHAN) 
Duration: 12 months
Official title of application: Mechanism of pain in paediatric Inflammatory Bowel Disease (PSG16-1)