Crohn’s disease and ulcerative colitis
Crohn’s disease and ulcerative colitis are chronic inflammatory conditions affecting the intestine. For individuals with these conditions there is a major impact on quality of life. Until recently the causes of these diseases were unknown, it has only been with the advent of molecular genetics techniques that the pathways involved in the pathogenesis have started to be determined.
The familial predisposition is such that individuals with close relatives are at increased risk of developing the same condition, but the individual risk is of the order of 3%. The objective of genetic research in inflammatory bowel disease is to determine the molecular basis for this increased susceptibility, and thus to illuminate the factors that cause the conditions with the potential to identify new treatments, prognostic factors and better target existing treatments.
The clinical and research focus of my unit is entirely based around inflammatory bowel disease (IBD). We run a large IBD clinic with a patient centred approach where different members of the team contribute to various aspects of patient care.
The application of genome wide association studies to Crohn’s disease has been very effective in identifying over 30 genetic loci that have been replicated and contribute to disease susceptibility. The Newcastle IBD genetics collection, which we have built up over the last 10 years, has been a major resource enabling these discoveries. We currently have more than 3000 IBD cases and continue to collect from around the Northern Region. Within that cohort we have nearly 500 individuals who have had surgical resection of the terminal ileum, which provides an excellent group in which to study the effect of genotype on post operative prognosis and on histological features of Crohn’s disease.
A complementary research interest is the application of biomarkers to clinical practice. We have recently published on the use of faecal biomarkers in post-operative Crohn’s disease, and have applied for support to run a large national study of using similar biomarkers to tailor anti-TNF treatment to the activity of an individual’s disease.
Dr M C Gunn
Mr F G Bergin
Dr S Bunn
Dr J Graham
Dr S Needham
A J Robinson
IBD nurse specialist
Maria Price and Samantha Ducker
Prof C G Mathew
Guy’s Hospital London.