Experts Outline New Agenda For Inflammatory Bowel Disease Research

Inflammatory bowel disease detection enhanced with PET/CT





The findings and recommendations of these expert workgroups are presented in a series of detailed "Challenges in IBD Research" reports, now available in Inflammatory Bowel Diseases, official journal of the CCFA. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. Each workgroup is assigned to specific topic areas including genetics, epidemiology and environmental factors, the "microbiome" (intestinal bacteria), epithelial cell biology, innate and adaptive immunity, clinical classification and prognostic models, and optimizing medical therapy. A special "Challenges in IBD Research" progress report appears in the March issue of Inflammatory Bowel Diseases. The complete workgroup reports are available for direct download at http://links.lww.com/IBD/A77. Experts Outline New Agenda for IBD Research Based on a thorough review in each area, the workgroups have defined key research priorities for the next few years, including: Defining clinically relevant subgroups of IBD patientsusing different types of information to predict aggressiveness of disease, complications, and response to treatment. Understanding the environmental factors affecting the risk and course of IBDincluding environmental "triggers" and a specific focus on the role of diet. Clarifying the complex interrelationships among genes, bacteria, and epithelial and immune responsesfocusing on cellular pathways and critical cell types that may lead to new "therapeutic targets." Determining the optimal treatment approaches and strategies through comparative effectiveness studies. The workgroup reports also identify the resources needed to carry out this ambitious research agenda, including a "centralized and distributable infrastructure" for integrated studies of IBD in humans and long-term follow-up studies of children and adults with IBD. "Through development of the ambitious research goals outlined in this document, the Crohn's & Colitis Foundation of America has again led the effort to further the understanding of IBD," said Dr. Lee Denson of Cincinnati Children's Hospital Medical Center. "CCFA is keen to advance this research agenda in 2013 and beyond." Building on Recent Scientific and Clinical Advances The CCFA research agenda builds on recent advances in scientific and clinical research. They include major strides in IBD geneticsmore than 160 genes affecting susceptibility to Crohn's disease and ulcerative colitis have now been identified. Using sophisticated techniques, researchers have gained new insights into the complex interactions between intestinal bacteria and immune responses, including the role of specific types of immune cells. Clinical studies have improved the ability to predict the response to IBD treatment in children and to track the short- and long-term adverse effects of IBD treatments. Progress has also been made in understanding the risks and benefits of medical and surgical treatments for key patient subgroups, including pregnant women and newborns. helpful site http://www.news-medical.net/news/20130325/Experts-outline-new-agenda-for-inflammatory-bowel-disease-research.aspx









Typically assessed by endoscopic and histologic evaluations, investigators demonstrated the ability of PET/CT to identify lesions along the complete intestinal wall that could be missed with traditional imaging techniques. "Animal models of intestinal inflammation have contributed substantially to the current understanding of IBD; however, endoscopic examinations on the animals can be complicated, and full histological workup of the murine colon does not allow for serial assessment," said Dominik Bettenworth, MD, lead author of the study "Translational 18F-FDG PET/ CT Imaging to Monitor Lesion Activity in Intestinal Inflammation ." "In this study, we evaluated 18F-FDG PET/CT as a noninvasive approach to serially assess IBD activity in small animals and confirmed its utility by analyzing PET/CT scans conducted in patients with Crohn's disease." For the first phase of the study, researchers induced dextran sodium sulfate (DSS) colitis in mice and assessed the 18F-FDG uptake in multiple sections of the colon. Compared with control mice , an increase in 18F-FDG uptake was clearly noted in the DSS mice, with the most intensive areas of uptake in the medial and distal colon. Significant correlation was found between the PET/CT and histologic evaluations. The experiment also identified extraintestinal alterations, such as bone marrow activation, in the DSS colitis-induced mice. Based on the results of the experiments in the colitic mice, researchers identified the extent of the mucosal damage as the parameter that correlated best to 18F-FDG uptake in the mice and in human patients with Crohn's disease. 18F-FDG PET/CT scans of 25 Crohn's patients were retrospectively analyzed, and the findings were then correlated to endoscopic procedures performed before or after the CT without any interfering treatments. In accordance with the results in the DSS colitis, an increased 18F-FDG uptake was found in 87 percent of deep mucosal ulcerations, whereas mild endoscopic lesions were detected in approximately 50 percent of patients assessed. "In Crohn's disease patients, 18F-FDG PET/CT seems to accurately detect advanced inflammatory changes and also unmask subepithelial disease activity that might be missed by colonoscopy. Therefore, PET/CT might serve as an additional tool for evaluating disease activity in IBD patients, e.g., in defining complete remission," noted Bettenworth. Michael Schafers, MD, senior author of the study, added, "Using a clinically established tracer, the translation of this approach into daily clinical routine should benefit patients in the near future and will further promote the use of PET/CT for new indications in clinical algorithms." Crohn's disease and ulcerative colitis are chronic-remittent, inflammatory conditions featuring characteristic mucosal lesions within the bowel leading to diarrhea, stricture formation, abdominal pain and weight loss. Crohn's disease may affect as many as 700,000 Americans, and ulcerative colitis may affect up to an additional 700,000; incidence rates for these diseases are on the rise worldwide. the full report http://medicalxpress.com/news/2013-05-inflammatory-bowel-disease-petct.html





Exercise And Inflammatory Bowel Disease: Scientists Find New Clues





"First, the effect of exercise on IBD needs to be clearly determined. If IBD is independent of exercise, then we need to determine whether there is merit in providing exercise guidelines to a patient population that has compliance difficulties due to the transitory nature of their symptoms." Also on HuffPost: Loading Slideshow Improved Sexual Function Here's a motivating reason to get moving: regular physical activity can increase blood flow in a way that has a direct affect on sexual function, explains HuffPost blogger David Katz, M.D., founding director of Yale University's Prevention Research Center At Griffin Hospital. In fact, a recent study published by Emory University researchers in the Journal of Sexual Medicine identified a link between physical activity and erectile function among men between the ages of 18 and 40. "The men in our study who exercised more seemed to experience a protective benefit against erectile dysfunction," study co-author Wayland Hsiao, assistant professor of urology at Emory School of Medicine, said in a statement. "We hope that early screening for ED may be a gateway issue to help motivate young men to live healthily on a consistent basis so that they can possibly avoid health issues associated with a sedentary lifestyle, such as diabetes and cardiovascular disease. We see this as just the beginning." Changes In Gene Expression In the burgeoning field of epigenetics, scientists are discovering how environmental factors, including diet, stress and toxins, can change the way our genes are expressed, essentially turning certain genes on or off, and affecting which are passed down from generation to generation. One factor that can play a role? Exercise. Two recent studies have illustrated just how regular physical activity can affect gene expression. The first study, conducted by Swedish researchers illustrated how inactive young adults demonstrated an immediate shift in their muscle cells' genetic material after just a few minutes on a stationary bicycle, HuffPost reported when the findings were released. The second study, conducted by researchers from the Harvard School Of Public Health, found that walking an hour a day can slash genetic tendencies toward obesity. We'll walk to that! Better Skin Sweating it out could help you get your glow on post-workout, too. check here http://www.huffingtonpost.com/2013/07/06/exercise-inflammatory-bowel-disease-colitis_n_3542283.html