Bulgarian Immunologist Develops New, Affordable Medication for Crohn's Disease

Immunologist Dr. Iliyan Iliev is working on the development of a new and more affordable medication for Crohn’s disease and ulcerative colitis in his laboratory in New York, as reported by bTV. His ambition is for the therapy to do more than simply suppress the immune system; he aims to “train” it to maintain the balance of microorganisms in the gut and control the growth of pathogenic species.

Chronic inflammatory bowel diseases affect millions of people worldwide, and their incidence is increasing. According to Dr. Iliev, the intestines are the “largest organ where the greatest battles are fought.” They are a site of continuous interaction between the immune system, food, and billions of microorganisms.

More than a decade ago, he turned his attention to a poorly studied component of the gut microbiome: fungi. While working at Cedars-Sinai Medical Center in Los Angeles, his team found that specific genetic mutations were observed in a subset of patients with severe forms of colitis and Crohn’s disease. By combining genetic data with microbiome analysis, the researchers discovered increased yeast growth in the intestines of these patients—an observation that was initially met with skepticism.

It later became clear that, in addition to bacteria, a fungal component permanently exists in the gut. Dr. Iliev’s team succeeded in mapping it and proving that the human body possesses a specific protein sensor for recognizing fungi. In patients with genetic mutations, this protein is not produced in sufficient quantities, which hinders the immune response. As a result, certain yeasts release a toxin that damages the intestinal mucosa and exacerbates inflammation.

Research continues at Dr. Iliev’s laboratory at Weill Cornell Medicine in New York. Data suggests that the interaction between fungi, the immune system, and the so-called “gut-brain axis” may have implications not only for inflammatory diseases but also for other chronic conditions, including neurodegenerative processes. The new medication the team is working on aims specifically to restore this disrupted balance through precise immune regulation, rather than through general suppression of the body’s defense mechanisms.