Immunome Research
Open Access

Immune System Imbalance and Dietary Approaches in the Treatment of Crohn’s Disease

Matteo Leone^{* *}Correspondence: Matteo Leone, Department of Immunity, University of Florence, Florence, Italy, Email:

Author info »

Description

Crohn’s disease is a chronic Inflammatory Bowel Disease (IBD) that affects the Gastrointestinal (GI) tract, leading to symptoms such as abdominal pain, diarrhea, weight loss, and fatigue. It is part of a broader category of autoimmune disorders, where the body's immune system mistakenly attacks its own tissues. The development of Crohn’s disease is centrally influenced by the immune system. In a healthy individual, the immune system is designed to protect the body from harmful invaders such as bacteria, viruses and other pathogens. However, in people with Crohn’s disease, the immune system malfunctions and starts attacking the healthy cells of the gastrointestinal tract.

The precise cause of this immune system dysfunction is not fully understood. However, it is believed that genetic factors, environmental triggers and an abnormal response to gut bacteria contribute to the immune system's overreaction. T-cells, a type of white blood cell, are involved in this process [1]. In Crohn’s disease, T-cells are overly activated and produce inflammatory cytokines, leading to the inflammation and damage of the intestinal lining [2]. This inflammation can result in the formation of ulcers, strictures, and sometimes fistulas, which complicate the disease. The body’s immune response to gut microbiota microorganisms living in the digestive tract also plays a significant role. In Crohn’s disease, the gut microbiome becomes imbalanced, which can further exacerbate inflammation [3]. This dysbiosis may contribute to the chronic nature of the disease and make it difficult to manage.

Sources of Crohn’s disease

While the exact cause of Crohn’s disease remains elusive, several factors contribute to its development:

Genetics: Family history plays an important role. Having a close relative with Crohn’s disease increases the likelihood of developing the condition. Certain gene mutations, such as those in the NOD2 gene, have been associated with an increased risk of developing IBD [4].

Environmental factors: Factors such as diet, smoking, and exposure to infections can increase the risk. For instance, smoking has been found to worsen the course of the disease and increase the likelihood of flare-ups [5]. Additionally, living in urban areas with higher levels of sanitation and hygiene has been linked to a higher incidence of Crohn’s disease, likely due to changes in the immune system’s ability to respond to microbial exposure [6].

Immune system dysfunction: As mentioned, Crohn’s disease is an autoimmune disorder, meaning that an abnormal immune response plays a pivotal role [7]. The body’s immune system mistakenly identifies harmless bacteria in the intestines as invaders and launches an inflammatory response.

Treatment options for Crohn’s disease

The treatment of Crohn’s disease aims to reduce inflammation, manage symptoms, and prevent flare-ups. While there is no cure, several therapies can help control the disease:

Anti-inflammatory drugs: These include corticosteroids and aminosalicylates, which help reduce inflammation in the gut. Immunosuppressants: Drugs such as azathioprine and methotrexate help suppress the overactive immune response, reducing inflammation.

Biologic therapies: These target specific immune system proteins involved in inflammation, such as Tumor Necrosis Factor (TNF) inhibitors (e.g., infliximab and adalimumab).

Antibiotics: Infections and complications like abscesses and fistulas can be treated with antibiotics.

Surgical treatment: In some cases, when medications fail or complications arise, surgery may be necessary. This can involve removing damaged sections of the bowel or repairing fistulas. Lifestyle and dietary changes: A modify diet plan can help manage symptoms and prevent flare-ups. Nutritional support, such as vitamin and mineral supplementation, may be required, particularly if nutrient absorption is impaired.

Immune-boosting foods for Crohn’s disease

While diet alone cannot cure Crohn’s disease, certain foods can help support the immune system and reduce inflammation [8]. An anti-inflammatory diet that emphasizes nutrient-dense, whole foods is essential for people with Crohn’s disease [9].

Omega-3 fatty acids: Found in fatty fish like salmon, mackerel and sardines, omega-3 fatty acids have strong anti-inflammatory properties that may help reduce the gut inflammation seen in Crohn’s disease.

Probiotics: Probiotics, such as those found in yogurt, kefir and fermented foods, can help restore a healthy balance of gut bacteria. This can potentially reduce inflammation and improve digestion, supporting immune function.

Fiber-rich foods: Although fiber may aggravate symptoms during a flare-up, high-fiber foods such as oats, chia seeds and lentils can be beneficial during remission. Fiber helps nourish the beneficial bacteria in the gut, promoting a healthy microbiome and boosting immune function [10].

Antioxidant-rich foods: Foods rich in antioxidants, such as fruits and vegetables (particularly leafy greens, berries and bell peppers), can help combat oxidative stress and support immune health. Vitamins A, C and E play an important role in reducing inflammation.

Turmeric: Curcumin, the active compound in turmeric, has powerful anti-inflammatory effects. Including turmeric in diet, either as a spice or in supplement form, may help reduce inflammation associated with Crohn’s disease.

Bone broth: Rich in collagen and amino acids like glutamine, bone broth can help heal the intestinal lining and reduce inflammation.

Crohn’s disease is a complex autoimmune disorder with a multifactorial origin, involving immune system dysfunction, genetic factors, and environmental triggers. While there is no cure for Crohn’s disease, treatments including medications, surgery and dietary modifications can help manage symptoms and improve quality of life. An anti-inflammatory diet that includes immune-boosting foods can complement medical treatments and support overall health. By understanding the mechanisms of the disease and taking a proactive approach to treatment, individuals with Crohn’s disease can better manage their condition and live healthier lives.

References

1. Goens D, Micic D. Role of diet in the development and management of Crohn’s disease. Curr Gastroenterol Rep. 2020;22(4):19

   [Crossref] [Google Scholar] [PubMed].

2. Henter JI, Horne A, Aricó M, Egeler RM, Filipovich AH, Imashuku S, et al. HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer. 2007;48(2):124-131.

   [Crossref] [Google Scholar] [PubMed].

3. Melero I, Castanon E, Alvarez M, Champiat S, Marabelle A. Intratumoural administration and tumour tissue targeting of cancer immunotherapies. Nat Rev Clin Oncol. 2021;18(9):558-576.

   [Crossref] [Google Scholar] [PubMed].

4. Crayne CB, Albeituni S, Nichols KE, Cron RQ. The immunology of macrophage activation syndrome. Front Immunol. 2019;10:119. 

   [Crossref] [Google Scholar] [PubMed].

5. Machaczka M, Vaktnäs J, Klimkowska M, Hägglund H. Malignancy-associated hemophagocytic lymphohistiocytosis in adults: A retrospective population-based analysis from a single center. Leuk Lymphoma. 2011;52(4):613-619.

   [Crossref] [Google Scholar] [PubMed].

6. Meshaka R, Fitzke HE, Barber J, Jones K, Taylor SA, Watson TA. Quantified small bowel motility assessment on magnetic resonance enterography in paediatric inflammatory bowel disease–does it reflect clinical response?. Pediatric Radiology. 2024;54(13):2210-2219. . 

   [Crossref] [Google Scholar] [PubMed].

7. Collins LE, Troeberg L. Heparan sulfate as a regulator of inflammation and immunity. J Leukoc Biol. 2018:105(1):81-92.

   [Crossref] [Google Scholar] [PubMed].

8. Avdonin PP, Rybakova EY, Trufanov SK, Avdonin PV. SARS-CoV-2 receptors and their involvement in cell infection. Biochem (Mosc) Suppl Ser A Membr Cell Biol. 2023;17(1):1-11.

   [Crossref] [Google Scholar] [PubMed].

9. Biancardi VC, Bomfim GF, Reis WL, Al-Gassimi S, Nunes KP. The interplay between Angiotensin II, TLR4 and hypertension. Pharmacol Res. 2017;120:88-96.

   [Crossref] [Google Scholar] [PubMed].

10. Penninger JM, Grant MB, Sung JJY. The role of angiotensin converting enzyme 2 in modulating gut microbiota, intestinal inflammation, and coronavirus infection. Gastroenterology. 2021;160(1):39-46.

    [Crossref] [Google Scholar] [PubMed]