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Dynamic Adhesion Assay for the Functional Analysis of Anti-adhesion Therapies in Inflammatory Bowel Disease
Published on: September 20, 2018
Pediatric inflammatory bowel disease: continuous lessons for adult inflammatory bowel disease
Shahzad Ahmed1, Cicily Vachaparambil, Subra Kugathasan
1aDivision of Gastroentology, Department of Medicine bDivision of Pediatric Gastroentology, Department of Pediatrics, Atlanta, Georgia, USA.
Insights
Pediatric inflammatory bowel disease (IBD) cohorts provide insights into disease progression and risk stratification. Studying genetic, microbiome, and tissue data at diagnosis improves personalized treatment strategies for IBD patients.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Immunology
Background:
- Inflammatory bowel disease (IBD) cohorts, particularly inception cohorts, are crucial for understanding disease progression and developing risk stratification strategies.
- Adult IBD care can benefit from lessons learned from pediatric IBD studies.
Purpose of the Study:
- To explore the utility of prospective and inception IBD cohorts for risk stratification and understanding disease natural history.
- To highlight advancements in pediatric IBD research and their implications for broader IBD management.
Main Methods:
- Analysis of genetic, serologic, and microbiome data from a multicenter pediatric IBD inception cohort.
- Examination of gene and protein expression in mucosal samples.
- Review of recent developments in IBD treatment and therapy.
Main Results:
- Development of a predictive model for IBD complications using diagnostic data.
- Identification of gut microbiome changes associated with disease severity and intestinal fibrosis markers.
- Demonstration of diagnostic and treatment efficacy information from mucosal gene and protein expression.
- Outline of advancements in treating growth failure, medication noncompliance, and dietary therapies in IBD.
Conclusions:
- Pediatric IBD research is enhancing phenotyping at diagnosis and developing molecular signatures for predicting disease behavior.
- Utilizing intestinal tissue over blood provides a more precise understanding of IBD.
- IBD is transitioning towards a better-defined condition with accurate risk stratification and individualized treatment based on biological and clinical data.
Purpose Of Review:
Prospective and inception inflammatory bowel disease (IBD) cohorts offer excellent opportunities to develop risk stratification strategies, use relevant tissue to explore the biology of IBD progression, and study the natural history of IBD in the era of biological therapy. Adult IBD care can learn important lessons from recent pediatric IBD studies.
Recent Findings:
A recent multicenter inception cohort of pediatric IBD patients examining genetic, serologic, and microbiome data at diagnosis has been able to create a model for prediction of disease complications, describe compositional changes in gut microbiota associated with disease severity, identify markers of intestinal fibrosis, and confirm how important early life environmental exposures affect disease severity and phenotype. Analysis of gene and protein expression in mucosal samples has been shown to offer both diagnostic information about differentiation of ulcerative colitis (UC) vs. crohn's disease as well as implications for treatment efficacy. Important developments in treatment of growth failure with antitumor necrosis factor therapy, the effect of oral medication noncompliance, and dietary IBD therapy are outlined.
Summary:
Pediatric IBD research has been focusing on better phenotyping at diagnosis, and development of molecular signatures of future disease behavior by using relevant intestinal tissue rather than blood. This has moved IBD from being a heterogeneous group of diseases with an unknown disease course to a better-defined condition in which patients are accurately risk stratified and treated based on individualized distinct biological and clinical information.
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