Inflammatory Bowel Disease (IBD) affects over 300,000 people in the UK. It is a long term, chronic condition, characterised by inflammation of the digestive system. The two main types of IBD are Crohn’s Disease, and Ulcerative Colitis, where the inflammation is confined to the colon. IBD is painful and debilitating, with a range of symptoms including diarrhoea, fatigue and weight loss.
The causes of IBD are unknown, so treatments currently depend on bringing the symptoms under control using anti-inflammatory drugs, followed by continual maintenance of the inflammatory condition to reduce the risk of recurrent flare-ups. In the most severe cases, surgery is the only effective treatment.
At the Quadram Institute we have brought together the interdisciplinary expertise needed to help understand the causes of IBD and develop innovative ways of treating it. Gastrointestinal clinicians in the QI Regional Endoscopy Centre are working alongside the scientists studying gut health, immunity, genetics and the microbiome, to understand how the complicated interplay between these elements and and elucidate how changes from the normal state link to IBD.
Understanding what changes when a healthy gut alters into a diseased state is a central part of the Quadram Institute’s research mission. The epithelial cells that line the gastrointestinal tract are a key part of the interface between gut bacteria and our immune system and we are investigating the role their renewal and cellular processes, like autophagy, may play in IBD. This also incorporates studying wider impacts on the immune system, including how immune cells react to gut microbes in IBD patients.
We are examining the role of the microbiome in IBD to understand the significance of changes in the microbiome that are seen in IBD patients. We are studying the mucus layer that provides a habitat and nutrition for gut microbes, as changes in the composition of this have also been seen in IBD patients. We want to get a better picture of the communication between microbes and the host to provide mechanistic evidence of the links between gut microbes and IBD.
The connections between gastrointestinal inflammation and liver disease are also being studied.
Within the Quadram Institute we have the expertise to study IBD at different levels, from the genetic and genomic basis of susceptibility, to studies on individual cells. We also work with organoid systems and other model systems to start to unravel the complex interactions between the components.
We have, in the Clinical Research Facility, and the Endoscopy Centre, state-of-the-art facilities under the same roof to be able to study IBD in patients and volunteers.