Simona Radice © ECCO

Ana Ibarra © ECCO

There are plenty of reasons why, as an Inflammatory Bowel Disease (IBD) Nurse, you should consider applying for this position, the first and foremost being to make a difference to the IBD nursing service across Europe and ultimately change the lives of patients with IBD.

Torsten Kucharzik  © ECCO

Up to 50% of patients with IBD suffer from extraintestinal manifestations (EIMs), which may impact every body system. EIMs are a source of considerable morbidity, and even mortality in the case of primary sclerosing cholangitis or venous thromboembolic events. Broadly, EIMs can be categorised as those resulting from inflammatory pathology at distant sites, the consequences of IBD and treatment, or wider associations. The underlying pathophysiology of extraintestinal inflammation is not fully understood. The systemic consequences of IBD lead to broader associations, including venous thromboembolic events and anaemia. Whether these are strictly EIMs is debated, but they result in great health burdens for our patients. 

The primary goal of the Educational Workshops organised by the ECCO Education Committee is to harmonise IBD practices within ECCO Country Members by presenting the practical use of the ECCO Guidelines on Crohn's Disease and Ulcerative Colitis.

Manuel Barreiro-de Acosta © ECCO

The 70^th ECCO Educational Workshop took place at the Hilton Bakirkoy Hotel in Istanbul, Turkey, on June 3, 2023. This event, the first ECCO Workshop of the year, brought together participants from Turkey and Romania and provided the perfect conclusion to the Turkish Inflammatory Bowel Disease Annual Meeting, which had started on the previous day. The workshop featured interactive discussion on various clinical scenarios and hot topics in IBD.

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.