Crohn's Research

Interaction of 2 genes implicated in the disease

A family history of Crohn’s disease led a father and mother, Gerald and Nancy Goldberg, to help shape the future by supporting genetic research at Cleveland Clinic.

Their children Peter and Betsy and a cousin all have Crohn’s, which affects an estimated 1 million Americans and has no known cure. The highest incidence of Crohn’s occurs in siblings.

The couple’s gift of $1.25 million, made two years ago, focuses on research into the role of genes in developing Crohn’s, a debilitating inflammatory bowel disease (IBD).

Gerald Goldberg devotes himself to learning about the disease, meeting with researchers, and attending medical conferences because, he says, “I have two children with Crohn’s, and my grandchildren will have 20 times the probability of having Crohn’s as the average person.”

Crohn’s has the strongest evidence of genetic influence, more than any other disease, says Claudio Fiocchi, MD, Professor of Molecular Medicine at the Lerner College of Medicine, staff member of Lerner Research Institute’s Department of Pathobiology and holder of the Clifford and Jane Anthony Chair for Digestive Disease Research and Education. His team is conducting research into the causes of IBD, which still are unknown.

“The current belief is that essentially all people with IBD and Crohn’s have an underlying genetic defect that, combined with environmental factors, triggers the disease,” he says.

Important findings have come of the research supported by the Goldbergs. The November issue of Gastroenterology, a leading medical journal in the field of digestive diseases, reports a study by Christine McDonald, PhD, and Jean-Paul Achkar, MD, colleagues on Dr. Fiocchi’s research team. Dr. Achkar holds the Kenneth Rainin Endowed Chair in IBD Research in the Digestive Disease Institute’s Department of Gastroenterology and Hepatology.

“The study describes how the interaction of two genes implicated in Crohn’s disease, NOD2 and ATG16L1, is altered and leads to a defective clearance of intestinal bacteria in this condition,” Dr. Fiocchi says. “Of note, the article is accompanied by an editorial by Dr. Ken Cadwell, New York University School of Medicine, a prominent microbiologist and geneticist, a sign of the particular importance of Drs. McDonald and Achkar’s findings.”

In a healthy person, the body’s immune system is switched on when defending against disease and returns to its normal resting state once the threat is gone. With Crohn’s, it never turns off.

“Either the ‘bad guy’ is not eliminated, or the mechanism that controls the immune system is not working well, or a combination of both,” Dr. Fiocchi says.

Medical treatment can help keep the disease in remission, and research is making a difference for people with Crohn’s, says Peter Goldberg’s gastroenterologist, Aaron Brzezinski, MD. “I think that advancement and understanding in the treatment of Crohn’s in the past five years has been greater than for the preceding 50 years.”

Through further genetic research, he says, physicians eventually may be able to identify the particular type of Crohn’s disease that a patient has and then predict disease behavior and provide treatment. “I hope that with better understanding of the genetic abnormalities in a given patient, we’ll be able to customize the treatment.”

In addition to their gift, Gerald Goldberg is the new Chairman of Cleveland Clinic’s Digestive Disease Institute Leadership Board, which helps raise financial support for the institute’s work. He combines his knowledge and passion about Crohn’s research with a lifetime of business and networking skills to engage other potential research supporters.

To make an online gift supporting the Digestive Disease Institute or any area of Cleveland Clinic, visit our secure giving site or call Institutional Relations and Development at 216.444.1245 or toll-free at 800.223.2273, ext. 41245.

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