Environmental Triggers is part of the five focus areas, including preclinical human IBD mechanisms, novel technologies, precision medicine, and pragmatic clinical research, described in the Challenges in IBD Research document.
The etiology of IBD has been extensively studied. However, the causative factors are not fully understood. The importance of genetic susceptibility has been established in the last decade and genetic risk variants have been identified, but the lack of complete gene penetrance and the rapid rise of IBD incidence in certain geographic regions suggest that the interaction between genetic and environmental factors contributes to IBD.
Thus, the future Environmental triggers research should be focused on elucidating the causality of environmental factors in IBD. Specific research gaps include: 1) epidemiology of exposures; 2) identification of signatures of biological response to exposures; and 3) mechanisms of how environmental exposures drive IBD.
Read more about environmental triggers in Inflammatory Bowel Diseases.
The Foundation is currently supporting several studies, investigating factors believed to play a role in IBD, such as diet, psychological, stress, viruses, and smoking. As the initiative advances, we hope to incorporate the study of other factors of relevance.
Diet (DINE-CD study)
A clinical research study, sponsored by the Crohn’s & Colitis Foundation and the Patient Centered Outcomes Research Institute (PCORI), to evaluate the effects of a nutrition-based intervention on patient outcomes. DINE-CD compares the effects of a Mediterranean diet and a Specific Carbohydrate Diet™ in reducing symptoms and reducing intestinal inflammation in Crohn’s disease patients.
Multi-institutional and multi-disciplinary research focused on understanding the effects of both early life and daily perceived psychological stress on the biological processes underlying IBD and development of flares. These studies aim to identify biological signatures, or measurable physiological parameters, that can be used in the clinic to predict stress-related disease relapse. These parameters include stress-dependent changes in inflammatory and vascular factors, microbiota diversity, microbial metabolic byproducts (metabolites), and central nervous system function via brain imaging. In addition to advancing our understanding of the biological response of patients to stress and how it relates to IBD onset and/or relapse, these studies will advance the emerging field of the gut-brain-axis communication, with implications that expand far beyond the field of IBD.
A multidisciplinary study focused on the role of viral infections on triggering IBD flares. The study is investigating whether specific viruses infecting human cells trigger overactive immune responses that lead to flares of IBD in patients. As part of this study, the investigators will develop an assay that can simultaneously detect in blood circulating antibodies against different types of viruses and their correlation to episodes of IBD flares in pediatric patients.
A pilot study focused on evaluating whether changes in a well-established blood biomarker of smoking correlates with severity of disease course.