Q&A with Dr. Randy Longman, IBD Researcher
Published: June 19, 2018
Please briefly describe your research interests in the relationship between joint inflammation and gut inflammation.
Randy: Many IBD patients – up to one third - experience significant extra-intestinal manifestations of the disease. The most common is joint inflammation. There are shared genetic and environmental factors underlying their combined pathogenesis – the process through which disease symptoms develop in the body.
Our lab focuses on the question of how the gut microbiome may increase or decrease inflammation throughout the body, including the joints. We have observed differences in the microbiomes of patients, depending on whether they do or not have IBD-associated joint inflammation.
Can joint inflammation be a sign of an IBD flare?
Yes. Joint inflammation can sometimes be an early sign of an IBD flare. If you are an IBD patient who experiences changes in how your joints feel, you should talk to your doctor.
What is precision medicine and how is it related to your research in IBD?
To me, precision medicine is really about using medicines more precisely – understanding the specific characteristics of each patient to support more informed decisions about which medicine to use in which context.
For example, our work is about the process of defining the activity of the immune cells in the blood or tissue, and of the molecules they produce. In Crohn’s associated arthritis, there may be larger numbers of a particular type of immune cell, which release a chemical factor called IL-23, that drives inflammation. However, this may not occur in all patients. If we had the ability to identify patients with higher levels of IL-23, then available therapies that inhibit this molecule, such as ustekinumab, might be more effective in those people.
Randy Longman is a gastroenterologist and Assistant Professor of Medicine at Weill Cornell School of Medicine. He is a recipient of the Crohn’s & Colitis Foundation Senior Research Award. He was interviewed by Gerard Honig from the Crohn’s & Colitis Foundation research team.