The Microbiome, Metabolome, and Genome in Multiplex IBD Family Clusters

该项目将寻求确定微生物和遗传因素对 在一个高危多发性（3个一级亲属）队列中发生炎症性肠病（IBD） IBD患者家庭。候选人：本申请的主要目的是支持伊丽莎白博士 斯宾塞的职业发展成为预防和治疗领域一名独立的、以患者为导向的调查员 为IBD患者提供个性化药物。斯宾塞博士的职业目标是成为一名独立的研究人员 在IBD的风险分层和预防应用方面处于领先地位。斯宾塞博士提出的训练 活动在五个领域：1）微生物组学，2）代谢组学，3）计算基因组学和宏基因组学， 4)纵向队列建设，以及5）领导。为了实现这一目标，她组建了一个指导团队， 博士Marla Dubinsky，西奈山IBD临床中心联合主任兼儿科主任 胃肠病学，IBD风险分层专家，Judy Cho博士，Ward-Coleman教授， 遗传学与基因组学与胃肠病学，查尔斯布朗夫曼个性化研究所所长 西奈山伊坎医学院（ISMMS）的医学（IPM），IBD遗传学专家， 博士耶利米信仰，遗传学和基因组科学和临床免疫学副教授， 微生物组翻译中心主任，微生物组学分析专家。环境：ISMMS 拥有优秀研究的悠久传统，是NIH资助的前20所医学院之一。的 西奈山儿科胃肠病学分部是IBD研究和临床护理领域的国际领导者。 研究：IBD是一种异质性的慢性炎症性疾病，由复杂的相互作用引起。 遗传、环境和微生物因素以及免疫反应。这些复杂的相互作用 在确定显性疾病之前，很难梳理出疾病背后的致病因素 考虑到临床前高风险队列的需要，多重家庭研究计划 ISMMS提供了一个独特的群体，受影响和未受影响的成员的多重家庭与IBD检查 这些因素的相对贡献。斯宾塞博士对这一群体的初步观察表明， 患有IBD的兄弟姐妹倾向于按出生顺序聚集在一起，可能是由于一些环境共享，这可能 是微生物的变化。我们希望通过表征微生物和 家族性IBD的遗传贡献，以改善那些在发展中国家的高风险分层， 和明显的IBD因此，我们的具体目标是（1）确定微生物和代谢组学谱的特征 在IBD的同胞群中及其与遗传风险的相关性，以及（2）制定IBD风险评分 结合遗传、微生物和代谢组学因素，并在类似的外部队列中进行验证。的 在该奖项期间开发的一般方法和技能可以应用于进一步的IBD风险分层， 继续探索IBD高风险人群可能的环境诱因。

This project will seek to define the relative risk contributions of microbial and genetic factors to the development of inflammatory bowel disease (IBD) within a cohort of high-risk multiplex (3 first-degree relatives affected) IBD families. Candidate: The primary objective of this application is to support Dr. Elizabeth Spencer’s career development into an independent, patient-oriented investigator in the field of prevention and personalized medicine for IBD patients. Dr. Spencer’s career goal is to become an independent researcher and leader in the application of risk stratification and prevention for IBD. Dr. Spencer’s proposed training activities are in five areas: 1) microbiomics, 2) metabolomics, 3) computational genomics and metagenomics, 4) longitudinal cohort building, and 5) leadership. To achieve this, she has assembled a mentoring team led by Dr. Marla Dubinsky, Co-Director of the IBD Clinical Center at Mount Sinai and Chief of the Division of Pediatric Gastroenterology, an expert in IBD risk stratification, Dr. Judy Cho, Ward-Coleman Professor, Vice-Chair of Genetics & Genomics & Gastroenterology, and Director of the Charles Bronfman Institute for Personalized Medicine (IPM) at the Icahn School of Medicine at Mount Sinai (ISMMS), an expert in the genetics of IBD, and Dr. Jeremiah Faith, Associate Professor of Genetics and Genomic Sciences and Clinical Immunology and Director of the Microbiome Translational Center, an expert in microbiomic analysis. Environment: The ISMMS has a strong tradition of outstanding research and is one of the top 20 medical schools in NIH funding. The Mount Sinai Division of Pediatric Gastroenterology is an international leader in IBD research and clinical care. Research: IBD is a heterogenous set of chronic inflammatory disorders that arise from the complex interplay of genetic, environmental and microbial factors, and immune responses. These complicated interactions arise before the identification of overt disease, making it difficult to tease out the causative factors behind disease inception given the need for a pre-clinical, high-risk cohort. The Multiplex Families Research Program at ISMMS provides a unique cohort of affected and unaffected members of multiplex families with IBD to examine the relative contribution of these factors. Dr. Spencer’s preliminary observations in this cohort have shown that siblings with IBD tend to cluster together in birth order, likely due to some environmental sharing, which could be attributed to microbial changes. We would like to explore this further by characterizing the microbial and genetic contributions to familial IBD to improve stratification of those at high-risk for developing both pre-clinical and overt IBD. Therefore, our specific aims are (1) to define the features of microbial and metabolomic profiles in sibling clusters of IBD and their association with genetic risk and (2) to develop an IBD risk score incorporating genetic, microbial, and metabolomic factors with validation in a similar, external cohort. The general approaches and skills developed during this award can be applied to further IBD risk stratification and continued exploration of possible inciting environmental triggers for those at high-risk for IBD.