More IBD in Israel

There is a "worrisome" increase in the prevalence in Israel of inflammatory bowel disease, experts say.

By JUDY SIEGEL-ITZKOVICH
Doctors perform surgery (generic) R 370 (photo credit: REUTERS/Swoan Parker)
Doctors perform surgery (generic) R 370
(photo credit: REUTERS/Swoan Parker)
There is a “worrisome” increase in the prevalence in Israel of inflammatory bowel disease (IBD), according to experts at a recent conference on the subject at Jerusalem’s Shaare Zedek Medical Center.
The symptoms of IBD – including the most common kind, Crohn’s disease – are tiredness, chronic diarrhea, stomach pains, weight loss and others systemic signs. About a quarter of patients are children, who are liable to suffer from delayed growth, said Prof.
Dan Turner, head of the Crohn’s disease and colitis center at SZMC.
Gastroenterologists say they know of between 20,000 and 40,000 local patients – adults and children – with IBD, and the numbers of new cases each year have quintupled since 1990.
Turner said he didn’t know the reason for the increase, but the meeting of gastroenterology experts from around the country could facilitate better understanding and treatment.
As many as 160 different genes are involved in IBD, but these are responsible for only a third of all cases, with the rest caused by the environment. Turner, a trained pediatric gastroenterologist, suggested that the increased use of antibiotics in infants may be responsible for at least some of the rise in prevalence, and that this risk is lower during other stages in life.
Breastfeeding, reduced exposure to environmental pollutants and even living close to farm animals are believed to lower the risk in children of IBD, he said.
Other research studies have suggested that children in large families are also more protected against the diseases, he concluded.
HELP FOR SKIN COLOR PROBLEMS
A new pigmentation clinic has opened at Tel Aviv Sourasky Medical Center’s dermatology department.
Patients who have too little or too much pigment in their skin due to disease are being treated.
The conditions include vitiligo (an autoimmune disease in which white spots appear on the skin due to destruction of pigments); pityriasis alba, a common skin condition that occurs mostly in children and usually shows up as dry, fine-scaled, pale patches on the face that go away by themselves; albinism (permanently white skin and hair due to a defective gene); melanoma, the most serious type of skin cancer; and postinflammatory hyperpigmentation, that can take up to a year to treat.
Many of these conditions affect patients’ day-to-day functioning and harm their self-image. Among the treatments are medications, phototherapy and lasers.
Dr. Mor Pavlovsky, a senior Sourasky dermatologist, runs the clinic, which operates on Sundays. For more information, call (03) 697-4000.
ORPHAN-DISEASE LOBBY
A lobby to assist patients who have rare genetic (“orphan”) diseases has been established by Hadash Party MK Dr. Afo Agbaria, a physician. As 0.05 percent of the population suffer from unusual disorders that are in many cases ignored by pharmaceutical companies and researchers because finding treatment is not profitable, incentives are needed to promote solutions for these unfortunate people.
Even If there are suitable drugs and other treatments, they are often not included in the basket of health services provided by the health funds, said Agbaria, who promises to work toward improvements.
KIDNEYS AND OVERWEIGHT
Obesity suppresses an important cellular process that prevents kidney cell damage, according to a study that recently appeared in the Journal of the American Society of Nephrology.
The findings suggest that restoring the process could protect the kidney health of obese patients. Obesity increases a chronic kidney disease patients’ risk of developing kidney failure, but the mechanism underlying this connection has remained unclear.
Dr. Kosuke Yamahara and Takashi Uzu of Japan’s Shiga University of Medical Science and their colleagues suspected that decreased functioning of a process called autophagy might play a role. This is a degradation system within cells that removes damaged proteins and other defective cellular components, and autophagy insufficiency is common in obese individuals.
The researchers found that in normal-weight mice with kidney disease, autophagy was active in kidney cells. However, in obese mice with kidney disease, autophagy was suppressed and kidney cells became damaged. Normal-weight mice with kidney disease and defective autophagy (due to a gene deletion) also experienced kidney cell damage.
The investigators also discovered that a potent suppressor of autophagy (called mTOR) was hyperactivated in the kidneys of obese mice, and treatment with an mTOR inhibitor relieved autophagy insufficiency.
Furthermore, both mTOR hyperactivation and autophagy suppression were observed in kidney specimens from obese patients with kidney disease.
“Obesity suppresses autophagy via an abnormal activation of nutrition-sensing signals in the kidney,” said Yamahara. “Our results suggest that restoring the kidney-protective action of autophagy may improve the kidney health of obese patients.”
In an accompanying editorial, Ken Inoki, PhD (University of Michigan) stated that “the results of this study provide an important pathomechanism underlying obesity-associated renal cell damage.”