Challenges in IBD Research

Since 1967, CCFA has been identifying the needs of the research community and developing action plans to meet those needs. As technology and science advanced, CCFA created a highly successful strategic plan known as Challenges in Inflammatory Bowel Disease (IBD) Research. Launched in 1990, this comprehensive plan has been updated periodically to reflect leading-edge scientific thinking and advances in research.

Over the years, CCFA has developed major research initiatives based on the Challenges directives. These include the DNA and Cell Line Bank, a repository of cell lines and tissue samples from patients and family members with IBD that researchers can use to expand their understanding of genetics. CCFA's Clinical Alliance comprises institutions that conduct clinical trials to answer questions that may not be addressed by other organizations, such as medical centers and pharmaceutical companies. In addition, CCFA-funded research grants meet the goals set forth in Challenges.

The 2002 update of the Challenges in IBD strategy is the most ambitious undertaking yet. Previous versions of Challenges focused primarily on basic research. To formulate the current plan, CCFA brought together leading basic and clinical scientists, who joined forces to identify the priorities and resources that are essential for moving research from the laboratory bench to the patient's bedside.  The resulting document sets forth nine areas that are key to accelerating the pace of research. By actively developing a group of related studies in each area, as well as raising the dollars necessary to fund these initiatives, CCFA is directing the course of IBD research.

The foundation has already raised more than $3 million to fund the first three areas, which will answer the most crucial questions.

Microbial Antigens and Responses  - Launched July, 2003

IBD has an environmental trigger as well as a genetic component. This trigger may be different for everyone. What's more, scientists do not yet know if the trigger is external (e.g., something found in our outside environment, such as a virus) or internal (e.g., an abnormal immune response to normally harmless bacteria that live in everyone's intestine).  By studying microbes and the body's response to them, researchers may be able to determine which environmental triggers are involved in IBD. This would provide essential information on the development and cause of Crohn's and colitis. 

Identification of Biomarkers for Colon Cancer in IBD  - Launched January, 2005

People who have had IBD for eight to ten years have a higher risk for colon cancer.  By identifying "markers"—early signs in blood or tissues—for dysplasia (precancerous changes in a cell) it will be possible to determine which patients are at risk.

IBD Epidemiology Study:  Collaboration with the Centers for Disease Control and Prevention and:

• Kaiser Permanente Research Institute - Launched October, 2002
• Massachusetts General Hospital- Launched October, 2007

Who has IBD, and who gets these diseases? The IBD Epidemiology Study seeks to ascertain the true extent of IBD in the United States. This large-scale population study, supported by a contract agreement with the Centers for Disease Control and Prevention (CDC), will present a truer picture of the diseases in the U.S. 

Kaiser Permanente Research Institute:
The Kaiser Permanente of Northern California is studying more than 7,000 IBD patients who were enrolled for at least one year as of January 1, 2001.  They are also exploring variations in how 75 gastroenterologists and primary care providers working at 20 clinics across Northern California treat their IBD patients with the goal to identify best treatment outcomes.  Patients were observed from 1995 through 2006, with predictors being assessed during the first half of the 12-year observation period (1995-2000), utilization of healthcare services during the second half (2001-2006), and drug therapy and disease activity throughout the entire 12-year period.  The group has published several papers to date and are preparing others on natural history of disease progression for both adult and pediatric patients; mortality; adherence and flare validation. 

Massachusetts General Hospital: Ocean State Crohn's and Colitis Area Registry (OSCCAR)
Massachusetts General Hospital, in collaboration with Rhode Island Hospital, has started a Crohn's and Colitis registry in the state of Rhode Island (nicknamed OSCCAR).  Rhode Island is an excellent location to conduct a demographic-based IBD study because it holds a small yet diverse population, and the limited number of gastroenterologists and physicians who see IBD patients make it easy to identify and recruit virtually every newly diagnosed patients.  To find out more information about this study please visit:
http://www.osccar.org   

Surrogate Markers - RFA submissions deadline July 1, 2007

Surrogate markers are tools that allow us to diagnose specific disease and to measure disease activity.  They may be found in a blood or stool sample. The presence of a specific molecule that plays a role in the immune response is one example of a possible surrogate marker. These markers are used to define or categorize the diseases into sub-types (Crohn's disease or ulcerative colitis); predict patterns of disease activity (patients at risk of developing arthritis, osteoporosis, skin lesions, etc.); predict response to different forms of therapy (who will respond, or not, to specific medical therapies); and help measure elements of disease that are specific in different forms of IBD.

Identification of Major Susceptibility Genes for Crohn's Disease and Ulcerative Colitis - RFA in development

Although several genes for IBD have been identified, further genetic studies to identify other susceptibility genes for Crohn's disease and ulcerative colitis are required.  This initiative would support projects that would identify susceptibility genes in chromosomal locations that have already been examined, as well as projects in which new approaches would be employed to identify the other IBD genes in the rest of the genome.

Development of a Detailed Understanding of Regulatory Cells in the Intestine  - RFA in development

Researchers need to have a better understanding of how the cells that control the immune system function, particularly in the intestine. The ability to regulate the immune response is a key factor in the onset and development of IBD.

The Challenges initiatives demonstrate CCFA's forward thinking in identifying a research need and providing the resource to meet that need. They also demonstrate CCFA's ability to partner with other institutions, including the National Institutes of Health (NIH) to make sure the best and the brightest minds in IBD and related fields are taking part in these endeavors. Though research discoveries in the laboratory, CCFA continues to lead the way toward developments that can be translated into new treatment therapies, and one day, a means to cure and prevent IBD.

Updated 12/30/08