Dear Friends and supporters of IBD Research at Washington University,

In this season of reflection and gratitude, my colleagues and I at the Washington University IBD Center are most grateful for your support of research directed at improving the lives of those affected by Crohn’s and Ulcerative Colitis. 2018 has been yet another remarkable year of growth and progress.  We have expanded our clinical program’s reach, developed new educational endeavors and made important progress in research.

This year we have added a new IBD specializing clinician to our group, Dr. Richard Rood.  Dr. Rood joins us from the University of Cincinnati where he was director of their clinical IBD program for several years. Beginning with clinical training at the University of Chicago, he has a wealth of experience in bringing comfort and healing to individuals affected by even the most challenging cases of Crohn’s and Colitis. He is also a passionate educator and a longstanding contributor to IBD research. Dr. Rood will see patients at both Washington University’s Center for Advanced Medicine at Barnes Jewish Hospital and at Barnes West County. He brings our IBD clinical group to a total of 11 skilled clinicians, making the Washington University IBD Program one of the largest the world.  Welcome Dr. Rood!

Our IBD group continues to lead innovative IBD research directed at making an impact for patients in the future and in the near term. As evidence of the significance of our IBD research efforts, I am proud to say that Mr. Michael Osso, President and CEO of the Crohn’s and Colitis Foundation, recently informed me that Washington University is once again, the top recipient of CCF research investments world-wide in 2018.  That’s 10+ years in a row! Below is a list of some of the exciting areas of active investigation:

  • Understanding the efficacy and potential side effects of IBD medications.  One study published this year revealed that IBD therapies other than steroids do not lead to infection outcomes in patients undergoing orthopedic surgeries such as hip or knee replacement.  This work can have immediate impact as surgeons frequently request that IBD medications be held before surgery, potentially setting patients up for an IBD flare after joint replacement surgery. This work was led by Drs. Martin Gregory and Deepak Parakkal.
  • Development of new blood based biomarkers for Crohn’s disease and Ulcerative colitis. This exciting field remains an active area of investigation by Drs. Parakkal and Ciorba. These blood and stool based biomarkers may eventually limit the need for some colonoscopies or CT scans. Dr. Ciorba was part of a team that published a study earlier this year showing that a single metabolite derived from the amino acid tryptophan may be able to predict colon healing. In January, Dr. Deepak received a 3 year, $300,000 grant from the American College of Gastroenterology to further his work in this area. The grant was nicely titled, “Triangular Phenotyping of Crohn’s Disease Activity”.  The preliminary data used to obtain this prestigious award was supported entirely by philanthropic donations! Thank you for your support and congratulations to Dr. Deepak!
  • Improving quality measures in IBD practice.  Dr. George Christophi has led a team who recently demonstrated that easily implemented clinical “nudges” can improve physician adherence and patient acceptance of preventative health measures important to IBD patients’ overall health. Among these measures is vaccination against pneumonia, an important cause of severe illness and even death in patients with Crohn’s and Colitis.
  • Target the gut lining “epithelial cells” in Crohn’s disease and ulcerative colitis.  WU IBD researchers have been world leading innovators in examining the function and role of this previously underappreciated cell type that forms the definitive barrier between the human body and the outside world (including food antigens, bacteria, fungi and viruses)!  Epithelial cell function is absolutely critical to healing the inflamed gut and sustaining long term health. We have made progress in two important areas related to gut epithelial cells this year.
    • Dr. Ciorba collaborated with IBD Scientists and colleagues Drs. Kelli VanDussen and Thad Stappenbeck who led a novel investigation examining the teeny-tiny hair like projections that enable epithelial cells to effectively absorb nutrition and defend against pathogens. They demonstrated that these hair like projects have consistent defects in patients with Crohn’s disease. Future work in this area will help understand if these defects may contribute to difficulty in healing and perhaps complications associated with Crohn’s. This work was published in the top scientific journal in our field, “Gastroenterology”.  Congratulations Professors!
    • Dr. Ciorba, along with Dr. Alexandra Gutierrez and GI Division Chief Nicholas Davidson, are leading a new study examining the therapeutic effect of a dietary supplement called Tauroursodeoxycholic acid (Tudca for short) in ulcerative colitis. This safe and well-tolerated, currently available supplement has the unique ability to help epithelial cells fight off the toxic effects of stress.  Yes, even epithelial cells can get stressed out.  In fact, the inflammation that occurs in IBD can be very taxing to the health of epithelial cells and cause them to die, leading to “holes in the wall” of the gut that can perpetuate inflammation even further.  This study was recently selected for funding by the Crohn’s and Colitis Foundation’s Litwin IBD Pioneers Award mechanism.  This program funds high risk, high reward projects that have the potential to rapidly impact clinical care in IBD.  What an honor!

We actually have many more innovative and paradigm changing projects being pursued by Washington University IBD investigators.  However, I will save some for next year when I hope to share updates on the topics discussed above and provide new information on our exciting studies examining the interaction between dietary fat, obesity and IBD. Trust me, it will be BIG news J!

Research provides the foundation upon which medicine will be practiced in the future, but even now, there remains a vast amount of knowledge to be shared on how to most effectively provide care to IBD patients today.  For this reason, Washington University IBD Program faculty continue to lead cutting edge patient and professional education endeavors. This year we launched an annual continuing medical education course called, “New Advances in IBD and Cases Studies”.  This program, hosted last April, attracted more than 120 physicians from our region and across the United States. On the same day, we co-hosted an exceptional  patient education event with the Crohn’s and Colitis Foundation.  In 2019, we will expand our educational endeavors through these types of events and through our newly created Advanced IBD Fellowship program. This program provides the opportunity for a fully trained gastroenterologist to dedicate an additional year to gaining specialized skills in clinical management of Crohn’s and Ulcerative colitis.  Our first Advanced IBD Fellow will be Dr. Anas Gremida who joins us from the University of New Mexico. We are delighted to welcome Dr. Gremida!

In all, 2018 has been a highly fulfilling year with progress made across our mission goals of advancing IBD research, clinical care and education.  We dedicate ourselves fully every day to make a difference for those affected by IBD. As we work together in this marathon, we sincerely and humbly appreciate your support and partnership in these endeavors.  You are our inspiration and motivate us to do our best. We wish each of you a healthy and happy new year and welcome you  to reach out to me or any of my colleagues if you would like to learn more about the work we do.

Sincerely,

Matthew Ciorba, MD
Director, IBD Program and IBD Research
Associate Professor of Medicine
Division of Gastroenterology
Washington University School of Medicine