Predicting disease behaviour in Paediatric Inflammatory Bowel Diseases
The course of IBD varies substantially between individuals, ranging from very mild disease requiring minimal or even no treatment, to a severe, treatment-resistant, chronically debilitating course. The latter disease phenotype is characterised by frequent relapses requiring rapid escalation of increasingly potent immunosuppressive therapy, as well extensive surgical intervention. Despite exhaustive studies to determine useful predictors of disease behaviour, we are still unable to advise children and parents at the point of diagnosis on disease outcomes, and hence are unable to propose a tailored, more individualised and potentially more effective treatment strategy. Increasing evidence suggests that early, stratified treatment of risk groups (i.e. with severe disease phenotype) is likely to improve long-term disease outcome.
A second focus of our lab is to improve our understanding of disease behaviour in order to identify disease prognostic biomarkers. This aims to allow a more personalised approach to treatment, and thus lead to an improved outcome. Epigenetic profiles, such as DNA methylation of disease relevant cell types, are prime candidates to serve as disease prognostic biomarkers. Access to a well defined patient cohort allows us to effectively test these hypotheses.