Inflammatory Bowel Diseases

Prasad, Shalini; Cross, Raymond K; Monroe, Mary Beth; Dolinger, Michael T; Motte, Rachel; Hong, Sungmo; Stidham, Ryan W; Kumar, Narendra; Levine, Deborah; Larijani, Anthony; Simone, Ashley; Chachu, Karen A; Wyborski, Russell; Heller, Caren A; Moss, Alan C; Schwerbrock, Nicole M J; Selaru, Florin M

2024 Inflammatory Bowel Diseases

doi: 10.1093/ibd/izae082pmid: 38778625

Novel technology is one of the five focus areas of the Challenges in Inflammatory Bowel Disease (IBD) Research 2024 document. Building off the Challenges in IBD Research 2019 document, the Foundation aims to provide a comprehensive overview of current gaps in IBD research and deliver actionable approaches to address them with a focus on how these gaps can lead to advancements in interception, remission, and restoration for these diseases. The document is the result of a multidisciplinary collaboration from scientists, clinicians, patients, and funders and represents a valuable resource for patient-centric research prioritization.Specifically, the Novel Technologies section focuses on addressing key research gaps to enable interception and improve remission rates in IBD. This includes testing predictions of disease onset and progression, developing novel technologies tailored to specific phenotypes, and facilitating collaborative translation of science into diagnostics, devices, and therapeutics.Proposed priority actions outlined in the document include real-time measurement of biological changes preceding disease onset, more effective quantification of fibrosis, exploration of technologies for local treatment of fistulas, and the development of drug delivery platforms for precise, location-restricted therapies. Additionally, there is a strong emphasis on fostering collaboration between various stakeholders to accelerate progress in IBD research and treatment.Addressing these research gaps necessitates the exploration and implementation of bio-engineered novel technologies spanning a spectrum from materials to systems. By harnessing innovative ideas and technologies, there’s a collective effort to enhance patient care and outcomes for individuals affected by IBD.

Ananthakrishnan, Ashwin N; Gerasimidis, Kostantinos; Ho, Shuk-Mei; Mayer, Emeran; Pollock, Jennifer; Soni, Shefali; Wu, Gary D; Benyacoub, Jalil; Ali, Basmah; Favreau, Alex; Smith, Denise Elsbree; Oh, Ji-eun; Heller, Caren; Hurtado-Lorenzo, Andres; Moss, Alan; Croitoru, Ken

2024 Inflammatory Bowel Diseases

doi: 10.1093/ibd/izae085pmid: 38778624

Environmental factors play an important role in inflammatory bowel diseases (IBD; Crohn’s disease, [CD], ulcerative colitis [UC]). As part of the Crohn’s & Colitis Challenges 2024 agenda, the Environmental Triggers workgroup summarized the progress made in the field of environmental impact on IBD since the last Challenges cycle in this document. The workgroup identified 4 unmet gaps in this content area pertaining to 4 broad categories: (1) Epidemiology; (2) Exposomics and environmental measurement; (3) Biologic mechanisms; and (4) Interventions and Implementation. Within epidemiology, the biggest unmet gaps were in the study of environmental factors in understudied populations including racial and ethnic minority groups and in populations witnessing rapid rise in disease incidence globally. The workgroup also identified a lack of robust knowledge of how environmental factors may impact difference stages of the disease and for different disease-related end points. Leveraging existing cohorts and targeted new prospective studies were felt to be an important need for the field. The workgroup identified the limitations of traditional questionnaire-based assessment of environmental exposure and placed high priority on the identification of measurable biomarkers that can quantify cross-sectional and longitudinal environmental exposure. This would, in turn, allow for identifying the biologic mechanisms of influence of environmental factors on IBD and understand the heterogeneity in effect of such influences. Finally, the working group emphasized the importance of generating high-quality data on effective environmental modification on an individual and societal level, and the importance of scalable and sustainable methods to deliver such changes.

Syed, Sana; Boland, Brigid S; Bourke, Lauren T; Chen, Lea Ann; Churchill, Laurie; Dobes, Angela; Greene, Adam; Heller, Caren; Jayson, Christina; Kostiuk, Benjamin; Moss, Alan; Najdawi, Fedaa; Plung, Lori; Rioux, John D; Rosen, Michael J; Torres, Joana; Zulqarnain, Fatima; Satsangi, Jack

2024 Inflammatory Bowel Diseases

doi: 10.1093/ibd/izae084pmid: 38778628

Precision medicine is part of 5 focus areas of the Challenges in IBD Research 2024 research document, which also includes preclinical human IBD mechanisms, environmental triggers, novel technologies, and pragmatic clinical research. Building on Challenges in IBD Research 2019, the current Challenges aims to provide a comprehensive overview of current gaps in inflammatory bowel diseases (IBDs) research and deliver actionable approaches to address them with a focus on how these gaps can lead to advancements in interception, remission, and restoration for these diseases. The document is the result of multidisciplinary input from scientists, clinicians, patients, and funders, and represents a valuable resource for patient-centric research prioritization. In particular, the precision medicine section is focused on the main research gaps in elucidating how to bring the best care to the individual patient in IBD. Research gaps were identified in biomarker discovery and validation for predicting disease progression and choosing the most appropriate treatment for each patient. Other gaps were identified in making the best use of existing patient biosamples and clinical data, developing new technologies to analyze large datasets, and overcoming regulatory and payer hurdles to enable clinical use of biomarkers. To address these gaps, the Workgroup suggests focusing on thoroughly validating existing candidate biomarkers, using best-in-class data generation and analysis tools, and establishing cross-disciplinary teams to tackle regulatory hurdles as early as possible. Altogether, the precision medicine group recognizes the importance of bringing basic scientific biomarker discovery and translating it into the clinic to help improve the lives of IBD patients.

Allegretti, Jessica R; Bordeianou, Liliana G; Damas, Oriana M; Eisenstein, Samuel; Greywoode, Ruby; Minar, Phillip; Singh, Siddharth; Harmon, Sabrina; Lisansky, Eugene; Malone-King, Myisha; Litwin, Nicole S; Weaver, Alandra; Heller, Caren A; Moss, Alan C; Adler, Jeremy

2024 Inflammatory Bowel Diseases

doi: 10.1093/ibd/izae083pmid: 38778623

Pragmatic clinical research is 1 of the 5 focus areas of the Challenges in IBD Research 2024, a multidisciplinary effort by scientists, clinicians, patients, and funders to identify priorities for patient-centric research. This summary provides a comprehensive overview of current gaps in inflammatory bowel disease (IBD) clinical research and actionable approaches to address them. This review is focused on identifying research that is needed to achieve the best outcomes for patients in clinical practice. Research gaps include understanding the needs of understudied patient groups and addressing barriers to care so all patients receive optimal care, validating and using biomarkers to enable early diagnosis and result in better outcomes for adults and children with IBD, and determining the optimal sequencing of treatments (medical, surgical, adjunct) in children and adults. Inclusive pragmatic research is needed to address these gaps and lead to improvements in patient care and outcomes for all populations of patients with IBD.

Ciorba, Matthew A; Konnikova, Liza; Hirota, Simon A; Lucchetta, Elena M; Turner, Jerrold R; Slavin, Anthony; Johnson, Kristen; Condray, Cass D; Hong, Sungmo; Cressall, Brandon K; Pizarro, Theresa T; Hurtado-Lorenzo, Andrés; Heller, Caren A; Moss, Alan C; Swantek, Jennifer L; Garrett, Wendy S

2024 Inflammatory Bowel Diseases

doi: 10.1093/ibd/izae081pmid: 38778627

Preclinical human inflammatory bowel disease (IBD) mechanisms is one of 5 focus areas of the Challenges in IBD Research 2024 document, which also includes environmental triggers, novel technologies, precision medicine, and pragmatic clinical research. Herein, we provide a comprehensive overview of current gaps in inflammatory bowel diseases research that relate to preclinical research and deliver actionable approaches to address them with a focus on how these gaps can lead to advancements in IBD interception, remission, and restoration. The document is the result of multidisciplinary input from scientists, clinicians, patients, and funders and represents a valuable resource for patient-centric research prioritization. This preclinical human IBD mechanisms section identifies major research gaps whose investigation will elucidate pathways and mechanisms that can be targeted to address unmet medical needs in IBD. Research gaps were identified in the following areas: genetics, risk alleles, and epigenetics; the microbiome; cell states and interactions; barrier function; IBD complications (specifically fibrosis and stricturing); and extraintestinal manifestations. To address these gaps, we share specific opportunities for investigation for basic and translational scientists and identify priority actions.

Heller, Caren; Moss, Alan C; Rubin, David T

2024 Inflammatory Bowel Diseases

doi: 10.1093/ibd/izae092pmid: 38778626

The mission of the Crohn’s & Colitis Foundation is to cure Crohn’s disease and ulcerative colitis and to improve the quality of lives of patients living with these diseases—in other words, to care and cure. To achieve these missions, there is a need to identify and prioritize research gaps and approaches to address these gaps, which is the aim of Challenges in IBD 2024. The Foundation convened close to 80 experts in inflammatory bowel disease (IBD), including researchers, clinicians, patients and caregivers, funders, industry representatives, and Foundation scientific staff and organized them into 5 workgroups, one for each of the 5 Challenges topics: Preclinical Human IBD Mechanisms, Environmental Triggers, Precision Medicine, Novel Technologies, and Pragmatic Clinical Research. The findings of these groups outline a research agenda that intends to change the research paradigm in IBD by introducing 2 concepts in the course of IBD that warrant specific focus: interception (during the preclinical phase) and restoration of normal physiology after remission is achieved. We hope these reviews will stimulate innovations in our understanding and management of IBD.