“What is my risk for Crohn’s disease?” Mount Sinai Hospital’s IBD team leads greater understanding through research

They are identifying factors that have strong associations with risk of developing Crohn’s. These breakthroughs will ultimately be used in tools to predict risk in healthy individuals while at the same time will help to define the cause of Crohn’s disease.

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The team, led by Dr. Ken Croitoru, a gastroenterologist at Mount Sinai and a scientist at the Lunenfeld-Tanenbaum Research Institute, has been working on the Crohn’s and Colitis Canada Genetic, Environmental, Microbial (GEM) Project for more than ten years. With a team of collaborators from around the world, the GEM Project has been recruiting healthy first-degree relatives of individuals with Crohn’s disease and looking at genetic, environmental and microbial factors that are present before disease occurs. This is one of the only ways to better understand how this disease develops.

“We want to understand individual risk for disease. Being able to tell someone their level of risk, be it high or low, is important, as we also explore how to intervene to prevent disease,” says Dr. Croitoru.

In a recent study published in Gastroenterology, the GEM Project team looked at anti-microbial antibody response to six microbial antigens.

“We report that increased anti-microbial antibody response is associated with future risk of developing the disease, even when measured more than three years before diagnosis,” says Dr. Sun-Ho Lee, the study’s first author and an IBD clinical research fellow working under the supervision of Dr. Croitoru.

“The study tells us that the antibodies are a marker of risk of disease. This suggests that there is something about the immune response to these microbes that is involved in the triggering of the disease. When you look at these markers, one of the questions might be, these patients might have disease but have not had symptoms. We also used a gut inflammation marker and showed – unique to the GEM Project – that the abnormal antibody test is not dependent on elevated gut inflammation, and in fact may precede the presence of gut inflammation,” says Dr. Croitoru.

Mount Sinai Hospital’s IBD program provides expert care for the largest group of IBD patients from across Canada, and is renowned as a highly specialized referral centre for complex IBD care. Additionally, the Zane Cohen Centre for Digestive Diseases is an internationally acclaimed clinical research facility and leader in the understanding and treatment of gastrointestinal diseases.

The GEM Project is generously supported by Crohn’s and Colitis Canada, The Leona M. and Harry B. Helmsley Charitable Trust, and Canadian Institutes of Health Research.