Investigating the role of microbiology in Crohn’s anal fistulae

Project: Investigating the role of microbiology in Crohn’s anal fistulae

Year: 2008

Researcher: St Marks Hospital

Background: An anal fistula is a chronically painful condition caused when the anal glands become blocked, resulting in the build-up of a very large abscess. Symptoms can include pain, discharge of blood or puss, itching and spread of infection.

The causes of Crohn’s anal fistulae are poorly understood therefore forCrohn’s funded work to analyse and understand the causes of fistulae.

Aims: Undertake microbiological analysis of anal fistulae to provide a greater understanding of fistulae and how to treat them.

Summary:
The following findings have never been observed before and have great significance for our understanding of anal fistula in Crohn’s Disease sufferers.

a) There was an absence of relevant bacteria in fistula puss – this is contrary to results obtained in previous research carried out in centres using less sophisticated techniques.

b) There was a lack of homing markers on dendritic cells, the cells that lead our immune system to target and fight areas of infection. This implies a chaotic and disordered immune response in the fight against fistula infection among Crohn’s Disease sufferers.
c) Fistula tract inflammation is driven from the luminal surface of the tract. This raises the fascinating question: if bacteria are not the luminal agent driving inflammation, then what is? This question is the subject of ongoing research at St. Mark’s.

The novel discoveries have raised the profile of Crohn’s anal fistula research and have prompted spin off research with potential therapeutic benefits.

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To apply for a research grant please contact us at [email protected].