Inflammatory Bowel Disease (IBD) – an umbrella term used to refer to Ulcerative Colitis, Crohn’s Disease, and other chronic inflammatory conditions affecting the intestine — is difficult to both diagnose and treat in patients. What makes IBD diagnosis and treatment particularly difficult is the similarity in symptoms between the conditions, which include diarrhea, fatigue, and weight loss. Once the diagnosis has been made, treatment options mostly include daily enemas, which tend to be uncomfortable and lead to harmful side-effects when absorbed by healthy tissues.
A team of scientists from Brigham and Women’s Hospital (BWH) in Boston along with colleagues from other research centers have developed a solution to improving IBD diagnosis and treatment, and have reported their findings in a new study published in Science Translational Medicine. The study outlined the concept of an enema in the form of a hydogel, which could be used once a week instead of the usual daily routine, and would target only inflamed tissues, sparing their healthy counterparts.
The hydrogel was formulated using ascorbic plamitate (AP), a material that is already approved for use in the United States. AP is negatively charged and anchors itself to positively charged sites of tissue damage. This formulation was incorporated in laboratory models via a corticodteroid drug commonly used to treat IBD. A key to the release of the hydrogel on inflamed sites only is the drug encountering an enzyme that is present in inflamed tissues, which was then tested in mice models genetically engineered to have Ulcerative Colitis. It was observed that, in comparison to routine enemas, the hyrogel-based formulation induced higher degrees of relief from inflammation. Also, the bloodstream of these mice had 5 to 10 times lower concentration of the drug than other enemas. Even tissue samples from human patients with ulcerative colitis showed the hydrogels preferring to stick to the inflamed sites rather than healthy tissues.
Researchers were optimistic about the technique and expressed their eagerness to see the technology further developed. Corresponding author Jeff Karp, an associate professor who headed a lab that develops advanced biomaterials and devices for therapeutics, said, “We realized that if we could develop a disease-targeted hydrogel system that rapidly attaches to ulcers and slowly release drugs at the site of inflammation, then we could create a better way to deliver medicine only where the drug is needed.”
Co-first author Dr. Sufeng Zhang, a chemical engineer who researches self-assembled hydrogels at the Massachusetts Institute of Technology (MIT) in Cambridge, added, “The materials we selected form a gel, which has the capacity to carry drugs. We designed the gel to both target inflamed tissue or ulcers and release drug only at sites of inflammation.”