Challenges in IBD Research: Environmental Triggers
Challenges in IBD Research: Environmental Triggers
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DOI：
10.1093/ibd/izz076
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发表时间：
2019-06-01
影响因子：
4.9
通讯作者：
Wu, Gary D.
中科院分区：
文献类型：
--
作者：
Ho, Shuk-Mei;Lewis, James D.;Wu, Gary D.
环境触发因素是IBD研究文件挑战的五个重点领域的一部分，其中还包括临床前人类IBD机制，新技术，精准医学和实用临床研究。IBD研究文件中的挑战全面概述了炎症性肠病（IBD）研究的当前差距，并提供了解决这些问题的可行方法。它是来自科学家，临床医生，患者和资助者的多学科投入的结果，代表了以患者为中心的研究优先级的宝贵资源。特别是，环境触发因素部分侧重于阐明IBD环境因素因果关系的主要研究空白。在以下方面确定了研究差距：1）暴露的流行病学; 2）识别对暴露的生物反应特征; 3）环境暴露如何驱动IBD的机制。为了解决这些差距，实施纵向前瞻性研究，以确定疾病的演变，并确定亚临床变化的暴露。这有助于确定脆弱性和风险预测的关键窗口。此外，系统生物学分析和计算机模拟被提出作为整合IBD基因组的方法，用于识别暴露反应的生物特征，并开发环境因素在驱动疾病活动和治疗反应中的影响的预测模型。这项研究可能导致识别暴露的生物标志物和新的治疗干预方式。最后，应进行假设驱动的机制研究，以了解基因-环境相互作用并验证优先因素的因果关系，以确定环境如何影响临床结局。
Environmental triggers is part of five focus areas of the Challenges in IBD research document, which also includes preclinical human IBD mechanisms, novel technologies, precision medicine and pragmatic clinical research. The Challenges in IBD research document provides a comprehensive overview of current gaps in inflammatory bowel diseases (IBD) research and delivers actionable approaches to address them. It is the result of a multidisciplinary input from scientists, clinicians, patients, and funders, and represents a valuable resource for patient centric research prioritization. In particular, the environmental triggers section is focused on the main research gaps in elucidating causality of environmental factors in IBD. Research gaps were identified in: 1) epidemiology of exposures; 2) identification of signatures of biological response to exposures; and 3) mechanisms of how environmental exposures drive IBD. To address these gaps, the implementation of longitudinal prospective studies to determine disease evolution and identify sub-clinical changes in response to exposures is proposed. This can help define critical windows of vulnerability and risk prediction. In addition, systems biology analysis and in silico modeling were proposed as approaches to integrate the IBD exposome for the identification of biological signatures of response to exposures, and to develop prediction models of the effects of environmental factors in driving disease activity and response to therapy. This research could lead to identification of biomarkers of exposures and new modalities for therapeutic intervention. Finally, hypothesis-driven mechanistic studies to understand gene-environment interactions and to validate causality of priority factors should be performed to determine how environment influences clinical outcomes.