Inflammatory Bowel Disease

CHEO’s IBD Centre conducts clinical and translational research to add to the growing literature on how to improve clinical care and to bring findings we have discovered in the research laboratories to patient care Our research is conducted at CHEO, the University of Ottawa

Canada has amongst the highest rates of IBD in the world. IBD is a chronic lifelong gastrointestinal disease for which the cause is unknown. The rate of IBD in children has increased by 50% since 1994. These statements provide the incentives for the CHEO IBD Centre Research Team. Greater understanding of disease process, predictors of outcomes and improving care are common themes of the local, national and international collaborations underway. Funding is currently through a number of sources including Ontario Genomics, Genome Canada, the Ontario Government, the Canadian Institutes of Health Research, and C.H.I.L.D. Foundation as well as local donors.

“We work on a greater understanding of children and young people with Crohn’s disease and ulcerative colitis, how better to care and treat these diseases and to determine how to improve outcomes. Fostering the development of clinical and research expertise both locally and beyond is an important avenue to both gain access and share improvement IN IBD health care practices. At the CHEO IBD Centre, we strongly believe in collaborative efforts and strive to be strong partners in North American and international IBD studies and initiatives. Our hope is that this will allow for a more rapid gain in knowledge, earlier implementation of the best new practices and improvements in pediatric IBD care which is a consistent goal and expectation of our research activities.”

Dr. David Mack – Director, CHEO IBD Centre

Research Projects

Analysis of Using the Total White Blood Cell Count to Define Severe New-onset Ulcerative Colitis in Children
24/08/2020

Conclusions: A combination of the white blood cell count, erythrocyte sedimentation rate, and either PLT or albumin is the best predictive subset of standard laboratory tests to identify severe from nonsevere clinical or mucosal disease at diagnosis in relation to objective clinical scores.
Widespread protein lysine acetylation in gut microbiome and its alterations in patients with Crohn’s disease
17/08/2020

In this study, the proteolytic peptides generated from each microbiome sample were aliquoted for both metaproteomics and lysine acetylomics analysis. Kac peptides from the first aliquot were enriched using a seven-plex anti-Kac peptide antibody cocktail; the second aliquot was directly analyzed for metaproteome profiling
Increased Intestinal Permeability is Associated with Later Development of Crohn’s Disease
10/08/2020

Increased intestinal permeability is associated with later development of CD; these findings support a model in which altered intestinal barrier function contributes to pathogenesis. Abnormal gut barrier function might serve as a biomarker for risk of CD onset.
Vedolizumab Therapy in Children With Primary Sclerosing Cholangitis
30/07/2020

Liver biochemistry worsened over time in IBD unresponsive to VDZ, but remained unchanged in IBD patients in remission. VDZ did not improve liver biochemistry in pediatric PSC-IBD. Progressive liver disease may be more common in patients with medically-refractory IBD.
Phenotypic Variation in Paediatric Inflammatory Bowel Disease by Age: A Multicentre Prospective Inception Cohort Study of the Canadian Children IBD Network
21/05/2020

Paris classification of age at diagnosis is supported by age-related increases in ileal disease until age 10 years. Other phenotypic features, including severity, are similar across all ages. Linear growth is less impaired in CD than in historical cohorts, reflecting earlier diagnosis.
Fecal Markers of Inflammation and Disease Activity in Pediatric Crohn Disease: Results from the ImageKids Study
15/05/2020

This study has confirmed that FC is useful, and overall best, marker to monitor mucosal inflammation in inflammatory bowel disease. FA12, however, appears to be a more suitable maker for prediction of mucosal healing in children.
CpG Methylation in TGFβ1 and IL-6 Genes as Surrogate Biomarkers for Diagnosis of IBD in Children
14/05/2020

We found that CpG methylation in the promoter of the TGFβ1 gene has high discriminative power for identifying CD and UC and could serve as an important diagnostic marker
Dietary strategies and food practices of pediatric patients, and their parents, living with inflammatory bowel disease: a qualitative interview study
15/12/2019

Our findings have important implications for the clinical care of pediatric IBD. Notably, IBD not only influenced the food practices of the pediatric patients, but also their parents and other family members. Healthcare professionals should consider the family unit when giving nutritional advice or developing nutritional guidelines. Personalized nutritional counselling and ongoing nutritional assessment are also warranted.
Analysis of Genetic Association of Intestinal Permeability in Healthy First-degree Relatives of Patients with Crohn’s Disease
19/10/2019

Excessive intestinal permeability or intestinal barrier dysfunction as measured by various assays has been observed in various diseases. However, little is known about the factors contributing to altered gut permeability in these diseases.
Anticipatory care of children and adolescents with inflammatory bowel disease: a primer for primary care providers
19/10/2019

High-quality care in pediatric IBD requires coordination between pediatric gastroenterologists and primary care providers, with careful attention paid to the specific needs of children with IBD.
Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn’s Disease
15/08/2019

Evidence-based medical treatment of Crohn's disease in children is recommended, with thorough ongoing assessments to define treatment success.
Clinical disease activity and endoscopic severity correlate poorly in children newly diagnosed with Crohn’s disease
01/02/2019

In children with newly diagnosed CD, wPCDAI correlates poorly with endoscopic disease activity. As treatment paradigms evolve to target mucosal healing, clinical markers should not be used in isolation to determine disease activity.
Symptoms do not correlate with findings from colonoscopy in children with inflammatory bowel disease and primary sclerosing cholangitis
01/07/2018

Children with PSC-IBD in clinical remission, based on PUCAI scores, have a significantly higher risk of active endoscopic and histologic disease than children with colitis without PSC. Fecal levels of calprotectin correlate with endoscopic findings in pediatric patients with PSC-IBD; levels below 93 μg/g are associated with mucosal healing.
Trends in Epidemiology of Pediatric Inflammatory Bowel Disease in Canada: Distributed Network Analysis of Multiple Population-Based Provincial Health Administrative Databases
01/07/2017

Canada has amongst the highest incidence of childhood-onset IBD in the world. Prevalence significantly increased over time. Incidence was not statistically changed with the exception of a rapid increase in incidence in the youngest group of children.
ACTIVE RESEARCH – Microbiome-based Precision Medicine in Inflammatory Bowel Diseases

Active Research - The primary objective of our proposed research program is to establish prognostic and risk stratification models for personalizing IBD therapy.