Using transcriptomics to ‘Treat to target’ in IBD

Current therapies in inflammatory bowel disease (IBD) can induce remission in many patients who were previously resistant to therapy, and rates of surgery has declined.  However, up to 50% of patients will still not have successful treatments either due to resistant disease or side effects from the medication.  Therefore, there is an unmet need to identify biomarkers that can predict response to treatment, in order to start patients on the optimum medication at the first opportunity rather than cycling through medications (which are associated with side effects) until one is found to be beneficial.

 The era of personalised medicine in IBD is on the horizon with techniques such as RNA sequencing with development of the analysis and affordability of this technology.

 We have developed a strategy to expose colonic biopsies and laminar propria mononuclear cells of IBD patients to disease relevant cytokines then extract the RNA and perform RNA sequencing.  From these samples, we aim to develop a list of key up and down regulated genes which are regulated by these cytokines and then interrogate both our own dataset and reposited datasets to see if this list of genes is enriched in active IBD and whether it can be used to predict response to medical therapies or adverse outcomes.