Relation between inflammatory diseases discovered

FAU researchers create family tree of chronic disease patterns

Inflammations are important defensive processes in the body that are usually temporary and healphysical damage. Chronic inflammations, however, are severe diseases: they can lead to permanent organ damage if they are not treated quickly. In experimental and clinical studies examining the effects of new pharmaceuticals, Prof. Dr. med. Georg Schett (Head of Department of Medicine 3) and Prof. Dr. med. Markus F. Neurath (Head of Department of Medicine 1) of Universitätsklinikum, FAU, together with international colleagues, discovered relations between the different types of chronic inflammatory diseases. The researchers have now published their findings and a family tree of various disease patterns in Nature Medicine.*

The symptoms vary: arthritis causes the painful destruction of joints, bones and the spine. Crohn’s disease attacks the intestinal walls and results in cramps and bloody diarrhoea. Psoriasis leads to a very distressing and sometimes even disfiguring chronic inflammation of the skin. A relationship between these inflammatory diseases is not apparent at first sight.
‘The relation between inflammatory diseases is often only a distant one, but sometimes it is a close, almost familial, relationship,’ explains Prof. Georg Schett. ‘Thanks to the prescription of modern drugs and reactions to them, we now understand that not all inflammatory diseases use the same mechanisms – but we were also able to find astonishing commonalities,’ says Prof. Schett. It is known, for instance, that almost all of these different diseases react well to the therapeutic inhibition of a certain inflammatory agent, the tumour necrosis factor (TNF).

Further commonalities between the individual diseases were determined: with regard to inflammatory messenger substances, for instance, there is a close connection between rheumatoid arthritis, a severe form of joint rheumatism, and giant cell arthritis, a rare form of vascular inflammation that occurs primarily in the elderly and can lead to dangerous occlusion of blood vessels.
There is another alliance between gout and certain types of infantile rheumatism: both diseases are strongly dependent on the inflammatory protein interleukin 1. Moreover, the researchers were able to find a connection between psoriasis and special forms of inflammation of the joints and spine.

There were similar findings for chronic enteritis: ‘Enteritis responds excellently to anti-inflammatory agents while other substances are not very useful or even harmful,’ says Prof. Markus F. Neurath. ‘Our research has also shown that there are anti-inflammatory agents that have an overall positive effect on the balance of organ functions. If we inhibit the wrong messenger substance in an inflammatory reaction, we can do more harm than good,’ Prof. Neurath summarises.
In light of these findings, the researchers agree that inflammatory diseases in particular require treatment by experienced specialists who can make the right diagnoses based on their understanding of the nature and function of the inflammation and choose a treatment accordingly.

*(Schett G, Elewaut D, McInnes IB, Dayer JM, Neurath MF.How Cytokine Networks Fuel Inflammation: Toward a cytokine-based disease taxonomy. Nat Med. 2013 Jul;19(7):822-4.).; doi: 10.1038/nm.3260. :

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