Pascal Juillerat  © ECCO

Dear ECCO Members,

What a wonderful ECCO Congress we had in Copenhagen! It was truly lovely to see everyone again at our first face-to-face Congress since 2020.

With summer just a week away, I am happy to update you all on the new and exciting content on the e-CCO Learning Platform.

In my previous letter, I mentioned the revamped, new-look platform. If you have not had the chance to explore it yet, I recommend that you take a look! 

I am happy to announce that we have introduced new content on the e-CCO Learning Platform:

During the recent ECCO Congress in Copenhagen, EpiCom said goodbye to Valérie Pittet and Behrooz Z. Alizadeh while Kristine Allin and Iago Rodríguez-Lago were welcomed as new Committee Members. We thank Valérie and Behrooz for their dedication to ECCO and wish them huge success in their future academic activities.

Maria Chaparro © ECCO

The study entitled "Withdrawal of anti-tumour necrosis factor in Inflammatory Bowel Disease patients in remission: a randomised placebo-controlled clinical trial" received one of the two Best Investigator-Initiated Study Award at ECCO’23.

Biologic anti-TNF drugs have been a game changer for patients with Inflammatory Bowel Disease. However, long-term maintenance of these drugs may be associated with potential adverse events and high costs. Therefore, patients and physicians are wondering whether it is possible to discontinue these drugs without significantly increasing the risk of recurrence.

Circulating tumour DNA and artificial intelligence as screening tools for dysplasia in Inflammatory Bowel Disease

Brecht Hens © Brecht Hens

Background & aim of research

Patients with colonic Inflammatory Bowel Disease (IBD) are at increased risk for the development of colorectal cancer. Surveillance colonoscopy is therefore advised, starting at 8 years after initial diagnosis of IBD and then repeated every 1–5 years based on the individual risk profile. However, screening based solely on colonoscopy is flawed as interval carcinomas still account for around 40%–50% of all colitis-associated carcinomas (CAC). In sporadic colorectal cancer, both liquid biopsies and artificial intelligence (AI) have proved to be feasible and to yield promising results. Patients with IBD were systemically excluded from these trials.

The aim of this research project is to improve the early detection of IBD-associated dysplasia by (1) developing non-invasive biomarkers using blood and/or stool samples to identify high-risk individuals and (2) developing a machine learning algorithm to aid in the detection of neoplastic lesions during colonoscopy.

Unraveling the role of fibroblast subsets in fibrostenotic Crohn’s disease

Andrea van der Meulen-de Jong, Marieke Barnhoorn, Luuk Hawinkels, Gianluca Matteoli © Marieke Barnhoorn

Objectives

Fibrosis occurs in most Crohn’s Disease (CD) patients, although it only becomes clinically apparent in those who develop stenotic disease. Fibroblasts are considered the main cell type contributing to fibrosis by production and remodelling of the extracellular matrix. Recently, changes have been shown in the relative abundance of different fibroblast subsets in the inflamed intestine of IBD patients. However, the abundance of fibroblast subsets and their spatial localisation in fibrostenotic IBD tissue are currently unknown. The overall aim of this project is to unravel the role of fibroblast subsets in the pathogenesis of fibrostenotic CD and to identify novel therapeutic targets.

As a first objective, we will map the differences in abundance and spatial distribution of fibroblast subsets in patients with inflammatory and stenotic CD using a unique 40-marker fibroblast Imaging Mass Cytometry (IMC) antibody panel. Thereafter, as a second objective, we will investigate (pathogenic) fibroblast subsets derived from fibrostenotic lesions in CD patients using a fibroblast-rich, three-dimensional organoid-based model. Lastly, we will assess in CD patients the effects of Janus kinase (JAK) inhibition on the relative abundance of identified fibroblast subsets.

Decoding molecular mechanisms and druggable targets of VEO-IBD by multimodal single-cell profiling

Daniel Kotlarz © Daniel Kotlarz

Objectives

The pathogenesis and course of Inflammatory Bowel Disease (IBD) are heterogeneous and have striking age-dependent characteristics. In particular, children with very early-onset IBD (VEO-IBD) show a higher incidence of unclassified IBD and develop courses different from adult-onset forms. VEO-IBD is a rare condition, but the incidence is increasing globally at an alarming pace. Notably, VEO-IBD patients often fail to respond to conventional therapies and show life-threatening conditions.

In paradigmatic studies, we have previously reported IL-10R deficiencies as a monogenic cause in children with intractable VEO-IBD. Based on knowledge of the molecular disease mechanisms, IL-10R-deficient patients could be cured by allogeneic haematopoietic stem cell transplantation. This prime example of translational research has shifted paradigms by demonstrating the relevance of genetics for the treatment of VEO-IBD patients. Our genetic screen of one of the largest international VEO-IBD cohorts has revealed disease-causing mutations in approximately 20% of analysed patients (>60 genetic entities) and suggested optimised treatment for a significant number of children. However, most VEO IBD patients still lack definitive diagnosis and the disease mechanisms remain largely elusive.

Travel awards ECCO'23 © ECCO

This year, available funding for ECCO Fellowships and Grants Programme (F&G) increased to 1.9 Million Euros for this year’s Call 2023 (to be awarded ECCO’24), this is the largest funding volume to date. With diverse funding streams for innovative research and international collaborations such as the Pioneer Award and the new Global Grant as well as those specifically for early career scientists, Dieticians and Nurses, the ECCO F&G Programme has really grown in the last five years.

IBD Intensive Course for Trainees © ECCO

The 22^nd ECCO IBD Intensive Course for Trainees designed for residents, fellows in gastroenterology and junior faculty will take place in Stockholm, Sweden, on February 21, 2024, immediately prior to our next Congress. We are pleased to inform you that the preliminary programme for this course is already available.

N-ECCO School © ECCO

At the 19^th Congress of ECCO in Stockholm, the Nurses of ECCO (N-ECCO) will host the educational activity for IBD Nurses, N-ECCO School, for the 15^th time. ECCO intends to give nurses, who might be still in training and have an interest in IBD, the possibility to attend an IBD-focused course. The ultimate aim of this programme is to improve nurse education throughout Europe.

The Educational Programme of the 19^th Congress of ECCO starts prior to the official start of the ECCO Congress and courses take place from February 21-24, 2024. These activities target ECCO’s different interest groups including young gastroenterologists, surgeons, paediatricians, pathologists, IBD Nurses, dietitians, allied health professionals and scientists.