Fungus may play key role in Crohn's, chronic intestinal inflammation

A recent study showed that three organisms work together to form digestive plaque biofilms capable of exacerbating intestinal inflammation, researchers say.
By Amy Wallace  |  Oct. 4, 2017 at 1:34 PM
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Oct. 4 (UPI) -- Researchers at Case Western Reserve University have found that fungi in combination with bacteria play a vital role in chronic intestinal inflammation disorders.

The study, published today in Digestive and Liver Disease, found that patients with Crohn's disease have much higher levels of the fungus, Candida tropicalis, compared to their healthy family members.

"I always knew that it was important to look at fungi because when people take antibiotics, especially women, it can cause fungal infection," Mahmoud A. Ghannoum, of the Center for Medical Mycology at Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, told UPI.

"I knew there was some connection but didn't know it also happened in inflammatory disorders. We found that they [fungi and bacteria] collaborate together to form the digestive plaque, or biofilm, found in the intestinal tract. What's bad about this type of biofilm with bad organisms is that it protects the biofilm from our immune system. In the gut, the fungi start to grow in such a way to invade the lining of our gut."

Researchers compared the gut bacterial microbiota, or bacteriome, and fungal community, or mycobiome, in members of families that had Crohn's disease to healthy family members.

They identified the microbial interactions leading to imbalance in the family members with Crohn's disease and found those with Crohn's had fungal Candida tropicalis and bacterial Serratia marcescens and E. coli imbalances in their gut microbiomes.

The study showed that the three organisms worked together to form digestive plaque biofilms capable of exacerbating intestinal inflammation.

"It [fungi] does not cause Crohn's disease, but it aggravates it and makes it worse," Ghannoum said. "Both, bacteria and fungi make the situation worse, they don't cause it. We really need to do more studies to find the cause and effect relationship. Because we know that they work together to make digestive plaque, using an antifungal and probiotic can work to inhibit the growth of the bad microorganism and encourage the growth of good ones."

Although the relationship between bacteria and fungi has been recognized in the gut, and the rest of the body, this study showed that bacteria and fungi actually work together to exacerbate the inflammatory symptoms in Crohn's disease. The results may lead to the development of novel treatment approaches and diagnostic tests for Crohn's and other debilitating digestive issues.

Potential treatments could include using antifungals and even probiotics that are designed to balance both bacteria and fungi, while breaking down digestive plaque biofilms. Antifungals will control the overgrowth of fungi, while probiotics can help restore and maintain the balance of the microbiota.

"We are now trying to understand the mechanism on how they work together, to be able to design a new treatment," Ghannoum said. "We are planning a clinical trial for using the antifungal and probiotic for treatment of the disease."

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