Researchers at the University of Glasgow have secured more than $3m to study the role the gut microbiome plays in post-operative outcomes for patients with Crohn’s disease.
The substantial grant, awarded by The Leona M. and Harry B. Helmsley Charitable Trust, marks the first time scientists will study how altering the gut microbiome through a 6-week treatment of specially formulated nutritional drinks could influence post-operative outcomes and disease recurrence in adult patients with Crohn’s disease.
This project is led by Professor Konstantinos Gerasimidis from the University’s School of Medicine, Dentistry & Nursing, in collaboration with Dr Athanasios Koutsos and Professor Simon Milling. The study builds on Professor Gerasimidis’ previous work in this field, exploring the relationship between diet and the gut microbiome of people with Crohn’s disease.
The MI-OCEAN (Microbiome analysis of the Optimisation before Crohn’s surgery using Exclusive Enteral Nutrition) study also includes collaborators from University Hospitals Birmingham NHS Foundation Trust, the Earlham Institute, the University of Birmingham and the University of Strathclyde. Researchers will explore whether changes in the gut microbiome induced by six weeks of pre-surgery Exclusive Enteral Nutrition (EEN) – a specially prescribed nutritional drinks which substitute a patient’s entire diet leading up to surgery – can predict post-operative outcomes, including wound infections, and reduce the risk of disease recurrence in adults with Crohn’s disease.
To achieve this, the team will compare changes in gut microbiome’s composition and function from patients receiving EEN prior to surgery with those maintaining their usual diets. The study team will also further investigate whether maintaining any EEN-induced microbial changes at six weeks and six months after surgery correlates with a lower risk of disease recurrence.
The MI-OCEAN team aims to identify the microbiome mechanisms that influence patients’ surgical outcomes and to better understand why some patients recover better than others. The team plans to use artificial intelligence to test whether including personal microbiome signatures in clinical data will enhance the prediction of patient outcomes, when compared with routine clinical data alone.
Professor Gerasimidis said: “We are delighted to receive this significant grant from the Helmsley Charitable Trust. Decoding the microbial mechanisms of action of EEN could help develop more tolerable dietary and pharmacological therapies and offer insights in underpinning pathogenesis of Crohn’s disease. Prognosticating risk of post-operative outcomes and subsequent disease relapse means preventive treatment strategies can be implemented promptly.”
Dr Shefali Soni, Program Officer at the Helmsley Charitable Trust said: “Helmsley is committed to supporting research that advances our understanding of the interactions between diet and gut microbiota in people with Crohn’s disease. This grant offers a unique opportunity to explore the role of gut microbiomes in surgical patients with Crohn’s disease receiving an EEN protocol. There is a need to investigate cost-effective measures that may reduce complications following surgery, an important management strategy for Crohn’s disease.”
The new MI-OCEAN will form part of the ongoing NIHR-HTA (National Institute for Health and Care Research-Health Technology Assessment Programme) funded OCEAN study, led by the University of Birmingham, which seeks to understand whether pre-operative EEN is clinically more effective to reduce post-operative outcomes compared with usual diet in patients undergoing surgery for Crohn’s disease. Although EEN shows promise as a pre-operative optimization strategy, randomized control trials are necessary before it can be part of the recommended Crohn’s disease management guidelines.
Dr Rachel Cooney, OCEAN Chief Investigator, University of Birmingham, said: “We are thrilled to receive this funding to expand the OCEAN study beyond the clinic to the laboratory. This work will help us understand how this diet impacts gut immunology, with the aim of providing more personalised care to people with Crohn’s disease.”
