Oral Crohn’s disease, also known as Orofacial granulomatosis (OFG), affects the mouth causing cracked swollen lips and painful ulcerations. It can occur alone or with Crohn’s disease (CD) in the gut and in many cases the oral disease is diagnosed first. This visible disease can occur in adolescence, be painful and have a negative impact on patients’ self-esteem. We know little about the cause of OFG because it is very rare making the process through which DNA changes lead to OFG tricky to study.
One goal for this study is to find out what changes in the DNA and the oral bacteria are unique to OFG. Another goal is to discover any measurable markers in patient samples that could indicate the presence of the disease. Answering these questions may help us learn how OFG develops and why some people go on to get CD of the gut and some don’t.
We will be doing two types of experiments to answer our questions. First, we will compare the DNA of OFG participants to that of OFG + CD participants and healthy participants so we can discover the DNA changes specific to each patient group. This requires a lot of patient participants, so we hope to combine those recruited via the NIHR IBD Bioresource (up to 600) with the 400 OFG patients we have recruited via our own local hospitals where this research study is based (Guy’s and St Thomas’ - GSTT). With the NIHR IBD BioResource, we can select CD participants who have been diagnosed with the oral disease and analyse DNA samples and/or data that have already been collected. Second, we will compare a wide range of additional markers and bacteria in other samples such as blood, saliva, and stool (poo) from OFG patients. We will collect these directly from patients that attend the OFG clinics at GSTT. We expect these studies to help us understand how OFG develops and why some patients get intestinal CD as well as helping us find clear markers for diagnosis and possible new treatments.
