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Examples of studies the IBD BioResource has facilitated

This page highlights some of the types of projects that have been facilitated by the IBD BioResource.

Access to data only

Researcher: Professor Miles Parkes, Addenbrookes Hospital

Project: Thiopurine monotherapy is effective in ulcerative colitis but significantly less so in Crohn’s disease: long-term outcomes for 11 928 patients in the UK inflammatory bowel disease bioresource

  • Data from the IBD BioResource were used to understand how effective thiopurine (azathioprine and mercaptopurine) treatment is in Crohn’s and Colitis. This study looked at thiopurine treatment alone (not used in combination with other medicines) – known as monotherapy. 
  • Thiopurine monotherapy was found to be effective in maintaining long-term remission in Colitis. But in Crohn’s it was not found to be as effective, particularly in people who have perianal Crohn’s.  
  • This may mean some people with Crohn’s should instead be offered combination treatment of thiopurines with biological medicines, rather than thiopurine treatment alone. This is because a combination treatment may be more effective. 

This study has now been published and the full article can be accessed here.

Real world data from people participating in the IBD BioResource has played a key part in understanding the role of azathioprine and mercaptopurine in the treatment of IBD. These drugs are clearly very effective in ulcerative colitis, but rather less so in Crohn’s disease where other, newer treatments may need to be added in.

Professor Miles Parkes, Cambridge University Hospital

Access to data and samples

Researcher: Professor Graham Lord, University of Manchester

Project: A Crohn’s Disease-associated IL2RA Enhancer Variant Determines the Balance of T Cell Immunity by Regulating Responsiveness to IL-2 Signalling

  • This study aimed to investigate the impact of a genetic change on the way 2 types of immune cells 'talk' to each other. These cells, called effector (Teff) and regulatory (Treg) are types of called T cells.
  • The researchers looked at Teff and Treg cells in blood samples provided by volunteers. They found that in people with the genetic change, the Teff were more sensitive to immune signalling.
  • The results of this study show a shift in the balance between Treg/Teffs, leading to a more 'aggressive' Teff in these individuals. This work may pave the way to become a target for personalised treatment in Crohn's disease.

This study has now been published and the full article can be accessed here.

Our study is one of the first to link a common genetic change which is associated with IBD to a biological change in immune cells.  We hope that this work will advance progress towards a personalised treatment approach for subjects carrying the genetic change. We are hugely grateful for the support of the NIHR IBD Bioresource in identifying and recruiting patients with and without the genetic change. Without the assistance of the staff and access to their IBD BioResource panel, we would not have been able to recruit patients from the rarest genetic type - those who carry two copies of the genetic change. The IBD Bioresource were also able to provide us with linked clinical data for the participants, so that we could examine whether the genetic change is linked to differences in the type and behaviour of IBD in patients.

Professor Graham Lord, University of Manchester

Recall study

Researcher: Professor Ailsa Hart, St Mark’s Hospital

Project: Crohn’s Anal Fistula Quality of Life Scale (CAF-QoL)

  • Perianal fistulas are often difficult to treat and can have a major impact on various aspects of life and its quality. Perianal fistulas connect the anal canal or rectum to the surface of the skin near the anus, where poo leaves the body. These fistulas are often very painful and can leak blood, pus and poo.
  • The Perianal Disease Activity Index (PDAI) is used to assess the status and response to treatment of perianal fistulas. The PDAI is completed by doctors and was originally developed without input from people living with the condition.
  • The aim of this study was to develop a new quality of life assessment scale with the help of people living with Crohn's-related perianal fistulas. Data from 211 people enabled the development of a final 28-item questionnaire.
  • The Crohn's Anal Fistula Quality of Life Scale (CAF-QoL) is a patient reported outcome measure. It can be used in research and clinical practice to capture impact on the individual alongside clinical evaluation.

This study has now been published and the full article can be accessed here.

The IBD BioResource was an integral part of our study demonstrating a new PROM, Crohn’s Anal Fistula Quality of Life Scale (CAF-QoL). It required ‘test-retest’ of questionnaires with a specific time frame in between, which meant lot of coordination of correspondences and communication between patients with the study team, with significant contribution from the BioResource. With the help of the team at NIHR BioResource, this provided the numbers of participants required and a smooth and timely communication between them.

Professor Ailsa Hart, St Mark’s Hospital

Scientific publications from projects using the IBD BioResource

Parkes M and IBD BioResource Investigators. The IBD BioResource: an open-access platform of 25 000 patients to accelerate research in Crohn's and Colitis. Gut. 2019 Jul 3. pii: gutjnl-2019-318835.

Stournaras E et al. Thiopurine monotherapy is effective in ulcerative colitis but significantly less so in Crohn’s disease: long-term outcomes for 11 928 patients in the UK inflammatory bowel disease bioresource. Gut. 2021 Apr;70(4):677-686. doi: 10.1136/gutjnl-2019-320185. Epub 2020 Oct 1.

Adegbola S et al. Development and initial psychometric validation of a patient reported outcome measure for Crohn’s perianal fistula – the Crohn’s Anal Fistula Quality of Life (CAF-QoL) Scale. Gut. 2020 Dec 3:gutjnl-2019-320553. doi: 10.1136/gutjnl-2019-320553. Online ahead of print.

Sazonovs A, Kennedy NA, Moutsianas L, Heap GA, Rice DL, Reppell M, Bewshea CM, Chanchlani N, Walker GJ, Perry MH, McDonald TJ, Lees CW, Cummings JRF, Parkes M, Mansfield JC, Irving PM, Barrett JC, McGovern D, Goodhand JR, Anderson CA, Ahmad T; PANTS Consortium. HLA-DQA1*05 Carriage Associated With Development of Anti-Drug Antibodies to Infliximab and Adalimumab in Patients With Crohn's Disease. Gastroenterology. 2019 Oct 7. doi: 10.1053/j.gastro.2019.09.041

Corridoni D, Shiraishi S, Chapman T, Steevels T, Muraro D, Thézénas ML, Prota G, Chen JL, Gileadi U, Ternette N, Cerundolo V, Simmons A. NOD2 and TLR2 Signal via TBK1 and PI31 to Direct Cross-Presentation and CD8 T Cell Responses. Front Immunol. 2019 Apr 30;10:958. doi: 10.3389/fimmu.2019.00958. eCollection 2019 

Goldberg R et al. A Crohn's disease-associated IL2RA enhancer variant determines the balance of T cell immunity by regulating responsiveness to IL-2 signaling. J Crohns Colitis. 2021 Jun 12:jjab103. doi: 10.1093/ecco-jcc/jjab103. Online ahead of print.

Alexander JL, et al. VIP study investigators. COVID-19 vaccine-induced antibody responses in immunosuppressed patients with inflammatory bowel disease (VIP): a multicentre, prospective, case-control study. Lancet Gastroenterol Hepatol. 2022 Apr;7(4):342-352. doi: 10.1016/S2468-1253(22)00005-X. Epub 2022 Feb 4.

Alexander JL, et al. VIP study investigators. COVID-19 vaccine-induced antibody and T-cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose (VIP): a multicentre, prospective, case-control study. Lancet Gastroenterol Hepatol. 2022 Nov;7(11):1005-1015. doi: 10.1016/S2468-1253(22)00274-6. Epub 2022 Sep 9.

Sazonovs A et al Large-scale sequencing identifies multiple genes and rare variants associated with Crohn's disease susceptibility. Nat Genet. 2022 Sep;54(9):1275-1283. doi: 10.1038/s41588-022-01156-2.Epub 2022 Aug 29. PMID: 36038634

 

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