|Ashwin Ananthakrishnan, M.B.B.S., M.P.H.
|Curtis Huttenhower, Ph.D.
|Ramnik Xavier, M.D., Ph.D.
|Gregory Lauwers, M.D.
|Dirk Gevers, Ph.D.
Assistant Director (Broad)
|Atul Bhan, M.D.
The Clinical/Tissue Core has been an important component of the CSIBD since its inception, serving as the nexus between investigators exploring the etiology and pathophysiology of the inflammatory bowel diseases and patients with these conditions. The Clinical/Tissue Core has supported the needs of researchers both within and external to the CSIBD through a number of highly organized efforts designed to facilitate connections between bench top and clinic, specifically the IBD and control patient base within the MGH Crohn’s & Colitis Center and the gastroenterology practice at Massachusetts General Hospital. To date, these efforts have included: 1) an extensive clinical database of patients with inflammatory bowel disease seen at the Massachusetts General Hospital, with detailed phenotypic and environmental information; 2) biopspecimen sample in the form of blood for genotypic analysis and next-generation sequencing, stool for microbiome analysis, urine for metabolomics and identification of novel inflammatory markers; 3) tissue sections from biopsies and resected specimens; 4) a serum bank; 5) immortalized lymphocytes from IBD probands, as well as their affected and unaffected first degree relatives; and 6) clinical research support for translational studies. These resources have evolved over the duration of the CSIBD as both needs and capabilities have evolved, and will continue to change and adapt from the current goals:
- To help to elucidate the phenotypic implications of disease loci with regard to clinical manifestations;
- To help in understanding the role of disease loci and other genetic variants related to immune mechanisms in predicted response or adverse effects related to existing therapies;
- To assist in understanding the functional implications of disease-variant associated genetic loci with regard to mucosal immunology and epithelial biology;
- To facilitate leveraging knowledge of the functional implications of disease-associated genetic loci to explicate environmental factors in the onset and expression of disease; and
- To promote the ability of investigators to capitalize upon observations in the functional biology of IBD to improve clinical diagnosis, prognostication, and treatment.
Clinical Database and Patient Identification:
The Clinical/Tissue Core maintains an active database encompassing patients with IBD seen at the MGH. Because the entire GI staff at the MGH participate in a common group practice organization and all are committed to the success of this project, it has been possible to capture nearly all relevant patients for this base. Retrospective review of hospital admissions, suggest that <5% of patients with an identified diagnosis of IBD are cared for without the participation of members of the GI group. Furthermore, as most of the small numbers missed by these criteria are admitted for surgical procedures, this group is identified through the activity of the tissue collection mechanisms of this core. Demographic data is available on all patients seen through the GI group and hospital at large. The database includes salient disease features: symptoms, duration, medications, location of disease (means of documentation), extraintestinal manifestations, endoscopy, surgery, pathology, family history, hospitalizations. Patients are also asked to indicate if they would be willing to participate in CSIBD related research activities through the PRISM cohort. CSIBD investigators with IRB-approved projects have access to this database to identify patients needed for study. An additional responsibility of this core is the recruitment of patients for specific study needs through notification of all MGH GI Unit practitioners.
- Tissue Samples
- Tissue Reference Bank
- Issue Sections
- Serum Bank
- This bank also includes serum from IBD patients not undergoing surgery according to the following categories:
- Ulcerative Colitis: Active/Non-active
- Universal/Left-sided/Rectum only
- Crohn's Disease: Active/Non-active
- Small Intestine/Colon/Both/Other
- Extraintestinal Manifestations
- Immortalized IBD Lymphocytes and DNA
- Clinical Research Support
- The Clinical/Tissue Core provides the means to undertake a complete spectrum of research in patients. Through the clinical resources of the MGH/GI Unit and the newly opened IBD clinical and clinical research facility and General Clinical Research Center of the MGH the following services can be provided:
- Patient Identification and Recruitment
- Endoscopic evaluation and procurement of tissue specimens
- Inpatient monitoring
- Radionuclide scanning and comprehensive radiologic services
- Bacteriologic Services
- Biostatistical Analysis