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Dynamic Adhesion Assay for the Functional Analysis of Anti-adhesion Therapies in Inflammatory Bowel Disease
Published on: September 20, 2018
Early-onset paediatric inflammatory bowel disease
James J Ashton1, Sarah Ennis2, R Mark Beattie3
1Department of Paediatric Gastroenterology, Southampton Children's Hospital, University Hospital Southampton, Southampton, UK; Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.
Insights
Early-onset pediatric inflammatory bowel disease (IBD) is rising globally. This lifelong condition impacts nutrition and well-being, with complex genetic causes and uncertain treatment outcomes requiring multidisciplinary care.
Area of Science:
- Pediatric Gastroenterology
- Genetics of Inflammatory Bowel Disease
- Autoimmune Diseases in Children
Background:
- Early-onset pediatric inflammatory bowel disease (IBD), diagnosed before age 10, is increasingly prevalent worldwide.
- This lifelong condition presents complex, multifactorial origins, significantly affecting a child's nutrition and psychological health.
- Over 200 genes are implicated in IBD, with 52 known to cause monogenic forms often appearing in infancy.
Purpose of the Study:
- To review the current understanding of early-onset pediatric IBD, including its genetic basis, clinical characteristics, and management challenges.
- To highlight the increasing incidence and severity of early-onset IBD compared to infantile- and adult-onset forms.
- To discuss the complexities in managing growth, puberty, and transition to adult care for these young patients.
Main Methods:
- Comprehensive literature review of early-onset pediatric inflammatory bowel disease.
- Analysis of genetic factors, including heritability and specific gene effects.
- Examination of current treatment modalities and their efficacy in pediatric populations.
Main Results:
- Early-onset IBD is characterized by a potentially higher genetic heritability and a greater severity than other forms of the disease.
- Long-term morbidity associated with early-onset IBD remains largely unassessed.
- The effectiveness of advanced therapies like monoclonal antibodies in early-onset IBD requires further investigation.
Conclusions:
- Early-onset pediatric IBD presents unique genetic and clinical challenges, demanding specialized, multidisciplinary care.
- Effective management requires addressing nutritional, psychological, and developmental needs alongside disease control.
- Further research is crucial to assess long-term outcomes and optimize treatment strategies for this growing patient population.
Abstract:
The incidence of early-onset paediatric inflammatory bowel disease is increasing worldwide. Defined as a diagnosis of Crohn's disease, ulcerative colitis, or inflammatory bowel disease unclassified before the age of 10 years, the disease is complex, multifactorial, and lifelong, and affects nutrition and psychological wellbeing. Over 200 genes have been implicated and a further 52 genes are known to cause monogenic disease, often presenting in infancy. Heritability of early-onset inflammatory bowel disease is hypothesised to be between that of infantile-onset (ie, <6 years old) and adult-onset disease, with genetic cause characterised by a few genes with modest or large effect size. Although early-onset disease is typically more severe than infantile-onset and adult-onset disease, long-term morbidity has not been assessed. Disease management is multifaceted and multidisciplinary, and is focused on the safe induction of remission and prevention of relapse. Although the advent of monoclonal antibody therapy has had a positive effect in the management of inflammatory bowel disease, treatment effects in early-onset inflammatory bowel disease are less certain. Additional challenges include maintenance of growth, navigation of puberty, and transition to adult services for long-term management.
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