Inflammatory Bowel Disease (IBD) – constituting of Crohn’s Disease and Ulcerative Colitis - affects approximately half a million people in the UK and can cause disabling symptoms, impaired quality of life, and serious complications. At present, treatment options are limited, costly, and can result in requiring major surgery. Even the best treatments available fail to keep the disease under control for one third of patients. Therefore, developing new treatments is vital to improving the future of those living with IBD.
In this research Dr Jennie Clough from King’s College London, investigates a theory that posits the role of a genetic change in the way that the intestinal immune system functions, which puts a person at risk of developing IBD. The study, which compares genetic data from healthy BioResource volunteers and patients from our IBD BioResource, aims to improve our understanding of treatments that may potentially benefit or harm patients with the genetic change.
Background to the study
IBD is believed to be caused by inappropriate activation of the intestinal immune system, triggering long-lasting inflammation of the gut. The intestinal immune system is comprised of immune cells, of which certain cells play a key role in both initiating and continuing this damaging inflammatory process.
Scientists have discovered that a genetic variation changes immune cell receptor behaviour, causing an imbalance between two important types of cells found in the intestine: regulatory T cells (Tregs), which suppress immune responses, and effector cells (Teffs), which can cause inflammation when overactive. In IBD patients who carry this genetic variation, existing medicine which acts to block this receptor could therefore be used to treat the underlying immune cell problem driving inflammation. Testing this theory in a laboratory environment, if successful, could lead to clinical trials in patients carrying the genetic variation and open the doors to a new treatment option for those living with IBD.
BioResource involvement
The study pulls data from two NIHR BioResource study applications, NBR79 looking at Crohn’s disease (CD) and NBR169 looking at Ulcerative Colitis (UC), to investigate if the genetic change may have a similar effect in patients with UC to those with CD.
IBD BioResource volunteers with CD or UC are age and sex matched with volunteers who do not have IBD so that the researchers can compare differences in the behaviour of immune cells between groups and those with or without the genetic variation. Volunteers were asked to provide an 80mL blood sample to be sent to the team in London, where the immune cells will be extracted in the laboratory for analysis.
Dr Jennie Clough speaks on the role of the BioResource in her research:
"I am so grateful to the team at the IBD BioResource, and the volunteers who took part, for enabling us to carry out this research. The genetic change we are studying is relatively common, with around 1 in 6 people carrying one copy of the genetic change. However, people who carry two copies are much less common – around 1 in 1000!
"Using the information held by the IBD BioResource has helped us to target recruitment of patients from each of these groups – work that would otherwise have been time-consuming or impossible for us to do from our own patients at the trust.
"We hope that this research will advance the understanding of which immune cells play a role in inflammation in IBD, and develop personalised therapeutic options for patients which are most likely to benefit them and least likely to harm them."
Volunteers who took part in the study
We spoke to two of the 18 volunteers that took part - one in the control group (no IBD present) and one with diagnosed CD - who participated in the study, and both visited the clinic in Cambridge for the first time.
Neil (pictured below), who has been a volunteer for approximately 3-4 years joined the BioResource via the NHS Blood and Transplant Service having been a long-time blood donor. Previously, he had participated in an online questionnaire for a dementia study.
He explains his motivations for taking part in this study:
“The NHS have been very kind to me and my family, in different ways over many years.
"You don’t know what’s coming around the corner, so, […] [taking part in research] could be helping me, it could be helping someone else.”
Andy (pictured at the top of the page), who has been a BioResource volunteer since 2016, joined via his clinician when he got diagnosed with Crohn’s disease. He explained to us the impact his condition has on his daily life, making it more difficult, and that he currently manages symptoms with a fortnightly self-injection, which is costly and not prescribed by the NHS. He hopes that by participating in research, it will “help other people” and lead to better treatment availability for people like him.
How can you get involved?
If you are interested in volunteering with the BioResource to be part of future research we support, whether or not you have a health condition, we’d love to hear from you. We not only recruit healthy volunteers and IBD patients, but also cover a wide variety of disease areas including Immune-Mediated Inflammatory Diseases (IMID), Mental Health, Non-Alcoholic Fatty Liver Disease (NAFLD), Rare Diseases, and, recently launched our DNA, Children + Young People’s Health Resource (D-CYPHR) for 11-15 year olds. All of our volunteers are consented to the NIHR BioResource and will be re-contactable to participate in further research, following standard protocols for being a BioResource volunteer.
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