CICRA

3 New Grants Awarded

Margaret — Sun, 13 May 2012 22:13:39 +0000

CICRA is pleased to announce that following peer review 3 research grants totalling almost £190,000 have recently been awarded to:

Professor David Wilson, Edinburgh Sick Children’s Hospital – a two year Research Fellowship for Dr Fiona Cameron - the study forms part of an overall aim of establishing a UK resource for the study of gene-environmental interactions in IBD

Dr Sarah Ennis, Southampton University – a three year PhD studentship (50% of the costs – the other 50% already secured) – the study is focused on rare genotype variants in the Paediatric IBD population. **

Dr David Bulmer, Barts & the Royal London - 2 year Research Project: Mechanisms of abdominal pain in childhood Inflammatory Bowel Disease

We would like to thank all those who have assisted us in reviewing the grant papers and also the Award Advisory Panel for helping us to select the best applications.

Please note that a further call for research applications will be made in September 2012 – if interested please re-visit the CICRA website later in the year for further details or contact CICRA now so we can notify you when Call opens.

** Dr Sarah Ennis holds a two year CICRA Research Project award and has just had a paper published in GUT

Royal Summer Variety – Hassocks

Margaret — Sun, 13 May 2012 19:10:26 +0000

A ‘ROYAL SUMMER VARIETY’ is planned for Friday 1st June in Hassocks. We intend, during the show to celebrate our Queen’s Diamond Jubilee and will even be going to ‘ROYAL ASCOT’!! We are inviting members of the audience to wear a hat fit for Ladies Day at Ascot (no fascinators though) and we will have a small prize for the person with the best hat. So please come along and join us for a 7.30p.m. curtain up at the Adastra Hall in Keymer Road, Hassocks. Admission will be the usual reasonable £4 for two hours of song, dance and those favourite audience singalongs with our local concert party Friends and Neighbours.

Advance tickets will be on sale from Monday 21st May from Pavilion Electrics in Keymer Road, Hassocks or by ringing me on 01273 845291. I look forward to seeing YOU there – please support this good cause.

Dorrie Mottram – West Sussex Rep. CICRA.

Oral Bacteria Differences in Crohns and UC

admin — Wed, 25 Apr 2012 23:10:47 +0000

This study from Harvard University examined brushings from the mouths of 114 children, some of whom had Crohn’s disease or UC and some of whom were healthy. The study identified all the bacteria present in the samples based on their genetic code. The overall bacterial populations differed between the healthy children and those with Crohn’s disease, but not when the same comparison was made against those with UC. A reduction in the variety of bacterial life was also seen in the children with Crohn’s, but not those with UC when compared with healthy children. When looking at specific groups of bacteria, there were differences in both Crohn’s and UC when compared with the healthy group, most notably in the bacterial group (phylum) Fusobacteria, but these changes were most prominent in Crohn’s.

It is well recognised that the inflammatory disease of UC is generally restricted to the colon whilst Crohn’s can affect any part of the gastrointestinal tract including the mouth. This study suggests there may be bacterial changes of direct relevance to this observation. The paper did not explore bacteria in other areas of the gut and did not study Crohn’s patient with active Crohn’s disease in their mouth specifically, but these would be interesting groups to examine and compare in future studies.

Click here for full article

More than genes? It’s all down to expression

admin — Sun, 01 Apr 2012 18:47:49 +0000

My last two blogs have focussed on our raw genetic code that scientists have previously shown can differ between those with and without IBD. It is now becoming clear that it is not only this raw code that differs, but also the way in which this code is “cracked”, leading to differing expression of certain proteins which may be partly responsible for the development of IBD.

The differences in the way genes are “expressed” is controlled by several different processes which together are called “epigenetics” (literally “over-genetics”). For many years scientists investigating cancer have been interested in these processes, but it is only recently that epigenetics has been studied in IBD.

In this month’s paper, scientists looked at the epigenetic profile of 40 people, as well as 16 children, with and without IBD. Using similar techniques as I’ve discussed in previous blogs, they looked at various areas along the entire length of each person’s DNA, but this time looking specifically at DNA methylation (a complex epigenetic process). They found significant differences between those with and without IBD, and most interestingly, in the same areas of DNA where we know the raw code is also different. Although this is only the first step in exploring this complicated area of science, it is hoped that understanding these changes more fully will allow a deeper insight into how IBD develops, and hopefully, suggest better ways to treat it!

Click here for full article

London CICRA day – 23 June

Margaret — Wed, 28 Mar 2012 20:22:48 +0000

CICRA’s next family event will be in London at the Institute of Child Health on Saturday 23rd June 2012. With the usual format there will be speakers (including a young person talking about their experiences) followed by a buffet lunch and informal discussion groups where you can ‘Ask the Expert’ about almost any aspect of Crohn’s and colitis in the young person

The teenagers will have their own session to ask their questions of a doctor, nurse and young CICRA Trustee in an open discussion about living and coping with Crohn’s and colitis plus any other subject that they wish – school, socialising, relationships etc.

If you have a child or teenager with Crohn’s or colitis in your family and would like to come along you will be very welcome . Please ring 020 8949 6209 or contact us

Great Day in Bristol

Margaret — Mon, 26 Mar 2012 21:50:15 +0000

A very successful CICRA Family Information Day was held on 17^th March and we thank everyone for coming – the members of the medical profession, parents, teenagers, younger children, grandparents and who all helped to make this informal day one of help and understanding to those with a family member with Crohn’s or Colitis. A report of the day will be posted here later.

CICRA Charity Lunch at Fontwell Park Racecourse 20 April 2012

Margaret — Sun, 25 Mar 2012 23:39:43 +0000

Come and join us for a fantastic day at the races and at the same time have the opportunity to support CICRA. Thanks to Dean Harding and family of Hardings Catering a special race day, sponsored by them, has been arranged for Friday 20 April 2012. For more information click on the link below, contact the CICRA office on 020 8949 6209 or to see if there are any hospitality packages still available ring Dean Harding on 01273 675676 .

Should you be at Fontwell on 20 April do please come and visit us at the CICRA booth.

http://www.fontwellpark.co.uk/horse-racing/fixture-details.php?detailId=165 .

IBD white blood cell patterns may reflect the severity of disease

Margaret — Sun, 11 Mar 2012 21:23:31 +0000

In the treatment of many diseases specific tests are used to identify patients who are going to have a worse disease course and therefore need additional treatments. The authors of this study found that particular white blood (immune) cells had an increased expression of their genetic code in patients who had a worse disease course in inflammatory diseases other than IBD. In IBD such a test is not yet available but this article suggests a possible area for the development of one. Such a test may help to identify which patients need early treatment with stronger drugs such as infliximab or conversely which patients will do well on mild treatments.

In this study specific white blood cells (CD8 T cells) were taken from the blood and the expression of genetic code was measured. Two very different patterns were found and labelled “IBD1” and “IBD2”. In both Crohn’s and UC the patterns were the same and interestingly they were also the same as in patients with other inflammatory diseases. 35 adults with Crohn’s disease and 32 with Ulcerative Colitis were recruited during active disease and studied for two years. In both Crohn’s and UC, patients with the IBD1 pattern were more likely to have persistent disease and require more intensive drug treatment than those with IBD 2.

These IBD patterns were better at showing the patients with the worst disease course than clinical signs used in routine current practice. This test is clearly at a very early stage but is an exciting prospect for the future.

Click here for full article

What’s the STORI? When to stop infliximab?

Margaret — Sat, 03 Mar 2012 15:45:31 +0000

This study is published by a group of hospitals in France and Belgium and looks at the risk of relapse after stopping infliximab in patients with stable Crohn’s disease who are well and also on a second immune-suppressing drug (usually azathioprine) [STORI is the terrible acronym that they have used, which seems to be necessary for clinical trials]. There were 115 patients with Crohn’s disease in the study, who had all been treated with infliximab for at least a year in combination with azathioprine, 6-mercaptapurine or methotrexate. They had all been well (in remission) for at least 6 months without steroids. All of these patients stopped their infliximab, continued their other medication, and were followed up for around 2 years to see if they relapsed (became unwell again from Crohn’s disease).

The rate of relapse was about 44% a year after stopping infliximab – almost half the patients. The authors were however able to determine factors that seemed to be able to predict relapse. The main factors appear to be male sex, the absence of surgery, three different blood tests, and a stool test. For example, with very few of these risk factors, 30% of the patients would have about a 15% risk of relapse in a year (compared to 44% above). These calculations require some quite complicated statistics, and the authors acknowledge the number of patients in the study was quite small given the predictions that they are making, and so should be interpreted with caution. It was reassuring that re-treatment with infliximab in those who relapsed was effective in almost all (88%). Also, there were no incidences of reactions to the drug after what was usually more than a 6 month break, which has previously been a concern when restarting infliximab.

In summary, STORI helps us decide which patients are safest to stop infliximab when well, and which are least safe, and also reassures us that restarting is usually successful and also appears to be safe. It must be remembered, however, that this was a particularly selected group of adult patients and so these results may not apply to all. We also have to be cautious when transferring these findings to children, as they are known to often have more extensive Crohn’s disease than adults.

Click here for full article

Does the immune system go to “school” in the gut?

Margaret — Thu, 09 Feb 2012 00:21:30 +0000

The body contains 10 times as many bacteria as “human” cells. Our immune system must therefore learn to live in balance with these bacteria. It is not fully understood how this is done, but immune cells called “T cells” (discussed previously) in the gut play a central role. Before birth our T cells are educated in an organ called the thymus. This education is to ensure that our T cells do not attack our own cells. It is not known how our cells learn to tolerate normal bacteria in the gut (“microbiota”), instead of attacking them like a nasty infection, for example Salmonella.

This research proposes a new method by which our T cells are taught to live with our normal microbiota. The scientists have conducted a complex series of experiments on genetically altered mice, to allow them to learn about T cell-bacteria interactions. In this system, some T cells, rather than being taught in the thymus, are educated directly by the microbiota in the colon, and this teaches them not to attack the bacteria, but to tolerate them. Intriguingly, it was shown that when this education did not occur, the mice developed colitis. While this is a mouse model only, it is a new concept in bacteria-human interactions in the gut, and may have profound implications for IBD research and future therapies.

Click here for the complete article