Assessing Predictors of Response to Anti-Tumor Necrosis Alpha Therapy in Early Crohns Disease

评估早期克罗恩病抗肿瘤坏死α疗法反应的预测因子

• 批准号: 9897566
• 负责人: RYAN UNGARO
• 金额: $ 18.93万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9897566
• 关键词: Advisory Committees; Affect; American; Anti-Tumor Necrosis Factor Therapy; Apoptosis; Architecture; Area; Award; Biological; Biological Markers; Biometry; Biopsy; Blood; Blood Proteins; Caring; Cellular Immunology; Characteristics; Child; Chronic; Clinical; Clinical Data; Country; Crohn' s disease; Data; Deposition; Diagnosis; Disease; Disease Progression; Drug toxicity; Early treatment; Environment; Exposure to; Extracellular Matrix; Failure; Funding; Gastroenterology; Gastrointestinal tract structure; Gene Expression; Gene Expression Profile; Genomics; Goals; Grant; Immune; Immunogenetics; Immunologic Monitoring; Individual; Inflammation; Inflammatory; Inflammatory Bowel Diseases; Institutes; Insurance; International; Intestinal Fistula; Intestines; Investigation; Laboratories; Leukocytes; Link; Longitudinal cohort; Mentors; Mentorship; Modeling; Molecular; Mucous Membrane; Necrosis; Oceans; Patient risk; Patients; Pattern; Pediatric Crohn' s disease; Pharmaceutical Preparations; Positioning Attribute; Process; Prospective cohort; Proteomics; Registries; Reporting; Research; Research Personnel; Resistance; Risk; Risk stratification; Sampling; Serum; Silicon Dioxide; Statistical Data Interpretation; TNF gene; Techniques; Therapeutic; Tissue Model; Tissues; Training; Training Activity; United States National Institutes of Health; Work; biobank; biomarker development; candidate marker; career; career development; clinical biomarkers; clinical care; cohort; cost; disability; disorder risk; health record; improved; individualized medicine; innovation; large bowel Crohn' s disease; longitudinal analysis; medical schools; microbial; news; patient oriented; peripheral blood; personalized medicine; population based; potential biomarker; predicting response; predictive marker; predictive modeling; recruit; response; response biomarker; side effect; single-cell RNA sequencing; skills; tissue biomarkers; tool; transcriptome sequencing; translational genomics; treatment optimization; treatment response; tumor; tumor necrosis factor-alpha inhibitor

This project will evaluate predictive biomarkers of response to anti-tumor necrosis factor alpha (anti-TNF) therapy in early Crohn's disease (CD) patients. Candidate: The primary objective of this application is to support Dr. Ryan Ungaro's career development into an independent patient-oriented investigator in the field of personalized medicine for inflammatory bowel disease (IBD) patients. Dr. Ungaro's career goal is to become an independent researcher and leader in the application of predictive biomarkers and models to select the best treatment and optimize care for recently diagnosed IBD patients. Dr. Ungaro's proposed training activities are in four areas: 1) advanced biostatistical analysis, 2) predictive biomarker analysis, 3) computational genomics, and 4) principles of immune monitoring. To achieve this, he has assembled a mentoring and advisory team led by Dr. Judy Cho, Director of the Charles Bronfman Institute of Personalized Medicine and an expert in translational genomics, and Dr. Bruce Sands, Chief of the Division of Gastroenterology, who has expertise in clinical and translational investigation of IBD therapeutics, having driven much of the pioneering research in anti-TNFs. Environment: The Icahn School of Medicine at Mount Sinai has a strong tradition of outstanding research and is one of the top 20 medical schools in NIH funding. The Mount Sinai Division of Gastroenterology is consistently considered one of the top 10 divisions in the country by US News and World Report and is an international leader in IBD research and clinical care. Research: CD is a chronic, progressive, inflammatory condition affecting the gastrointestinal tract. Anti-TNF medications have vastly improved the treatment of CD patients, however a significant number of individuals do not respond to these agents which are very costly and have potentially fatal side effects. New classes of medications for CD are being released bringing the opportunity for personalized medicine. Clinicians will need the tools to help decide which medication will work best for each individual CD patient. This will be particularly important in recently diagnosed patients since effective early treatment can decrease long-term complications. Therefore our specific aims are to (1) determine the association of peripheral blood proteomic markers with response to anti- TNF (2) assess the association of intestinal tissue gene expression markers with anti-TNF response and (3) explore the mucosal immune architecture and predictive capacity for anti-TNF response of single cell RNA sequencing (scRNASeq) of intestinal biopsies. We will study recently diagnosed CD patients (within 2 years of diagnosis) from 3 prospective cohorts with biosamples: a population-based IBD inception cohort, a multi-center cohort of recently diagnosed pediatric CD patients, and a single-center biorepository of IBD patients linked to health records data. In addition, a cohort of recently diagnosed CD patients will be recruited for scRNASeq analysis. The general approaches and skills developed during this award can also be applied to new targeted medications and form the basis for future research on biomarkers of treatment response in early IBD.

该项目将评估抗肿瘤坏死因子α（抗TNF）反应的预测生物标志物 早期克罗恩病（CD）患者的治疗。候选人：此应用程序的主要目标是 支持 Ryan Ungaro 博士的职业发展，成为该领域以患者为中心的独立研究者 炎症性肠病（IBD）患者的个性化医疗。 Ungaro 博士的职业目标是成为 一位独立研究人员和领导者，应用预测生物标志物和模型来选择最佳的 对最近诊断的 IBD 患者进行治疗和优化护理。 Ungaro 博士提议的培训活动是 四个领域：1) 高级生物统计分析，2) 预测生物标志物分析，3) 计算基因组学， 4）免疫监测原理。为了实现这一目标，他组建了一个指导和咨询团队，领导 作者：Judy Cho 博士，查尔斯·布朗夫曼个性化医学研究所所长、专家 转化基因组学，以及消化科主任 Bruce Sands 博士，他在以下领域拥有专业知识： IBD 疗法的临床和转化研究，推动了许多开创性研究 抗TNF。环境：西奈山伊坎医学院有着优秀的传统 是 NIH 资助最多的 20 所医学院之一。西奈山分部 胃肠病学一直被《美国新闻与世界》评为美国十大科室之一 报告并是 IBD 研究和临床护理领域的国际领导者。研究：CD 是一种慢性、 影响胃肠道的进行性炎症。抗 TNF 药物已广泛 改善了 CD 患者的治疗，但是相当多的人对这些没有反应 这些药物非常昂贵并且具有潜在的致命副作用。新一类治疗 CD 的药物是 的发布带来了个性化医疗的机会。临床医生需要工具来帮助做出决定 哪种药物最适合每位 CD 患者。这在近期尤为重要 诊断患者，因为有效的早期治疗可以减少长期并发症。因此我们的 具体目标是（1）确定外周血蛋白质组标记物与抗- TNF (2) 评估肠道组织基因表达标记物与抗 TNF 反应的关联，以及 (3) 探索单细胞 RNA 的粘膜免疫结构和抗 TNF 反应的预测能力 肠道活检的测序（scRNASeq）。我们将研究最近诊断的 CD 患者（2 年内） 诊断）来自 3 个具有生物样本的前瞻性队列：基于人群的 IBD 初始队列、多中心队列 最近诊断的儿科 CD 患者队列，以及与 IBD 患者相关的单中心生物储存库 健康记录数据。此外，还将招募一批最近诊断出的 CD 患者进行 scRNASeq 分析。该奖项期间开发的一般方法和技能也可以应用于新的目标 药物治疗，并为未来研究早期 IBD 治疗反应的生物标志物奠定基础。