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Cheryl Critchley
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Melbourne researchers are pioneering a new approach to treat the many people suffering inflammatory bowel diseases. The work will be funded by the Defense Advanced Research Projects Agency (DARPA), an agency of the US Department of Defense.

Inflammatory bowel diseases (Crohn's disease and ulcerative colitis) are common, chronic debilitating conditions. The increased incidence of inflammatory bowel disease (IBD) in war veterans may be stress-related.

Post-traumatic stress causes immune deficiencies which, in turn, can trigger lung, gut and other inflammatory illnesses.

The Florey Institute of Neuroscience and Mental Health is leading the four-year, $6.07 million project to study neuromodulation of inflammatory diseases with the University of Melbourne, the Bionics Institute and Austin Health.

DARPA is responsible for the development of emerging technologies for use by the military and for the welfare of military personnel.

While it is unusual for an organisation outside the US to be funded, the Melbourne researchers have been selected for their unique partnership of neurophysiologists, biomedical engineers, computer scientists and clinicians and for their novel approach to the treatment of inflammatory disease.

According to principal investigator, Professor Robin McAllen, inflammatory bowel disease is debilitating to patients and expensive to communities and health services.

“Current therapies are inadequate in terms of effectiveness, side-effects and cost. In the US, IBD, ulcerative colitis and Crohn’s disease combined, has an annual incidence of 13 to 17 per 100,000 people. Annually, this costs $6.3 billion in direct care, the productivity loss due to absenteeism is $3.6 billion and the personal suffering is huge,” Prof McAllen says.

Fellow principal investigator, Professor John Furness explains that these diseases are relapsing and remitting, beginning in young adulthood and continuing throughout life.

“Moreover, the prevalence of IBD is increasing,” Prof Furness says.

Professor Rob Shepherd, Director of the Bionics Institute and a principal investigator on the project, notes the strength of multi-disciplinary research in Melbourne citing the development of the cochlear implant and a bionic eye as examples.

“Therapeutic nerve stimulation for the treatment of inflammatory conditions is a novel approach that requires the specialist team of scientists, engineers, computer scientists and clinicians that we are able to bring together in Melbourne for its successful translation to the clinic,” he says.

The vagus nerve travels from the base of the brain to the chest and abdomen, carrying a wide assortment of signals to and from the brain. It supplies the heart, lungs, digestive tract, pancreas and other organs. It has only recently been discovered that it controls inflammation.

“The surgical team, led by Professor Bob Jones at Austin Health, has a strong record of innovation and they are renowned for establishing both the first liver and the first intestine transplant surgery in Australia,” Prof Furness says.

The team will create detailed functional and anatomical maps of the vagus nerve pathways, and will then determine optimal conditions to reduce IBD severity in pre-clinical animal models by electrically stimulating the nerve.

In a first-in-human clinical trial, the techniques developed in animals will be put to the test, using selective stimulation of vagal pathways to alleviate bowel inflammation in patients.