The ENIGMA Program - Bugs, Food and the Cause of Crohn’s Disease
East and West Working Together
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The ENIGMA (Eastern Gut Microbiota) program aims to identify the cause of Crohn’s disease, thereby improving treatment and identifying a pathway to cure. It explores how diet, gut bacteria, the environment, and inflammation are connected.
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Conducted in Australia, Hong Kong, and mainland China, ENIGMA is based on the premise that studying the factors that cause disease in countries where Crohn’s disease is common (Australia), was rare but now rapidly emerging (mainland China), and of intermediate but increasing prevalence (Hong Kong) will provide clues to the cause and cure of this disease.
The ENIGMA program includes people with Crohn’s disease, their unrelated household members, and close relatives. These groups often share either a similar environment or similar genes, but not both. Comparing these groups helps us to unravel whether certain risks are more likely linked to diet and lifestyle or to inherited traits.
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The ENIGMA program has made huge progress since its inception 15 years ago. Discoveries and achievements of the ENIGMA program to date:
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We have developed tools to measure food additive consumption and in the body.
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We have demonstrated that body food additive levels link to active Crohn’s disease.
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Westernisation of food, in particular the consumption of ultra-processed foods, is a risk factor for the development of Crohn’s disease, and for continued inflammation.
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People with Crohn’s disease are more likely to have eaten more processed foods, including additives such as artificial sweeteners and emulsifiers, during childhood.
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Food additives harm protective gut bacteria and promote harmful bacteria.
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Identification of a particular bacterium called Proteus that may play a central role in causing inflammation. Some food additives were found to help this bacterium grow and become more aggressive.
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Development of a new technique to study bacteria directly from the gut lining, offering better insight than stool samples alone.
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Created a non-invasive stool test that helps diagnose Crohn’s disease.
By showing how food, environment and gut bacteria interact, ENIGMA has highlighted how to prevent Crohn’s disease, improve diagnosis, and develop gut microbiome targeted treatments. The goal: decrease the burden of Crohn’s disease worldwide.
The ENIGMA program now aims to utilise its huge, collected information, using artificial intelligence, to:
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Gain a comprehensive understanding of the specific factors that lead to Crohn’s disease risk, cause active disease, and achieving remission.
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Define the role of specific food additives.
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Develop natural therapies, of “good” bacteria, to decrease the need for immune suppressing drugs.
Melbourne Clinical Staff
PROFESSOR MICHAEL KAMM
PROFESSOR OF
GASTROENTEROLOGY
The University of Melbourne,
St Vincent’s Hospital
DR. AMY HAMILTON
CLINICAL SCIENTIST
The University of Melbourne,
St Vincent’s Hospital
DR. AMY WILSON-O'BRIEN
CLINICAL SCIENTIST
The University of Melbourne,
St Vincent’s Hospital
DR. GINA TRAKMAN
RESEARCH DIETITIAN
The University of Melbourne,
St Vincent’s Hospital
Queensland Scientific Staff
PROFESSOR MARK MORRISON
PROFESSOR OF MICROBIOLOGY
The Diamantina Institute,
The University of Queensland
DR. SEUNGHA KANG
RESEARCH FELLOW
The Diamantina Institute,
The University of Queensland
Hong Kong Clinical and Scientific Staff
PROFESSOR SIEW NG
PROFESSOR OF GASTROENTEROLOGY
The Chinese University of Hong Kong
DR. WENDY ZANG
RESEARCH FELLOW
The Chinese University of Hong Kong