P-ECCO
13October2022

Personalised therapies in IBD: utilising next-generation sequencing data to direct treatment in monogenic disorders

Dror Shouval, P-ECCO Member

Dror Shouval
© ECCO

Over the past two decades, significant progress has been made in the understanding of the role of genetics in the pathogenesis of Inflammatory Bowel Disease (IBD): On the one hand, adult IBD studies have identified more than 250 single nucleotide polymorphisms that increase the risk of disease, though their individual and overall effect on the risk of developing IBD is small [1]. On the other hand, the expanding use of next-generation sequencing (NGS) platforms has resulted in the identification of more than 100 different rare monogenic disorders that directly cause IBD [2]. Given the central role of immune cells in sustaining immune tolerance in the gut, it is not surprising that in many cases monogenic disorders causing IBD result from pathogenic variants in genes involved in essential immune or epithelial pathways. Some patients with such disorders present with a clear immunodeficiency phenotype (e.g. chronic granulomatous disease, Wiskott-Aldrich syndrome), but in others IBD is the sole manifestation [3].

Posted in ECCO News, Committee News, Volume 17, Issue 3, P-ECCO

15June2022

New Committee Members in P-ECCO

Lissy de Ridder, P-ECCO Chair

Lissy de Ridder
© ECCO

As the new chair of the P-ECCO Committee, it is my pleasure to introduce two newly elected members of the Committee: Richard Hansen and Dror Shouval, two wonderful paediatric gastroenterologists from Scotland and Israel, respectively. Both are very active in the paediatric IBD field and they bring a wealth of expertise and energy to our group.

Posted in ECCO News, Committee News, Volume 17, Issue 2, P-ECCO

16December2021

Monitoring in Paediatric IBD

Marina Aloi, P-ECCO Member


Marina Aloi 
© ECCO

In the last decade the traditional management of Inflammatory Bowel Disease (IBD), based on clinically guided treatment intensification, has been revised and the so-called treat-to-target (T2T) approach, focusing on objective and scheduled measures to monitor intestinal inflammation, has been implemented in clinical practice, both in adults and in children. The general idea behind such tight monitoring is to prevent or block intestinal damage related to persistent and uncontrolled inflammation, and to avoid long-term complications.

Posted in ECCO News, Committee News, P-ECCO, Volume 16, Issue 4

29April2021

Pharmacokinetics of anti-TNFα agents in paediatric IBD: Is there any difference at all compared with adults?

Amit Assa, P-ECCO Member


Amit Assa 
© ECCO

Anti-tumor necrosis factor alpha (TNFα) therapy is frequently used in the treatment of Crohn’s Disease (CD) and Ulcerative Colitis (UC) in both adult and paediatric patients. Nevertheless, primary or secondary treatment failure of anti-TNFα treatment is not uncommon [1]. Both primary and secondary treatment failures are attributed either to pharmacokinetic, pharmacodynamic and immunogenic factors or to adverse events in response to the specific agent [2]. In recent years, loss of response (LOR) during anti-TNFα treatment has commonly been approached through the use of therapeutic drug monitoring involving measurement of infliximab or adalimumab trough concentrations (TC) and anti-drug antibodies (ADAs). Therapeutic drug monitoring of anti-TNFα agents enables proper stratification of LOR into a specific type of LOR, with corresponding adjustment of treatment. In children, in line with findings in adults, it has consistently been shown that higher drug TC is associated with higher efficacy [3] and that LOR is most commonly attributable to either low TC or the development of anti-drug antibodies [4].

Posted in ECCO News, Committee News, Congress News, P-ECCO, Volume 16, Issue 2

25March2021

8th P-ECCO Educational Course at ECCO' 21

David Wilson, P-ECCO Chair

David Wilson
© ECCO

Although the relationship between IBD and nutrition is of longstanding interest, the attention paid to it has increased dramatically in recent years, with the inclusion of nutritional interventions in ECCO Guidelines on both paediatric and adult Crohn’s Disease (and of course many other IBD guidelines), bespoke publications such as the ECCO perioperative dietary therapy topical review and a flowering of clinical interest in Crohn’s Disease-specific diets.

This clinical interest in nutritional issues in IBD is also reflected in the exceptional interest in a December 2020 educational article in the UEG Journal “Mistakes in…” series, namely “Mistakes in nutrition in IBD and how to avoid them” by the ECCO Members Joe Meredith, Kostas Gerasimidis and Richard Russell (ueg.eu/a/268). Basic and translational scientific studies of the pathogenesis of IBD have increasingly evaluated the role of nutrition and particularly its interaction with the microbiome.

Posted in ECCO News, Committee News, Congress News, P-ECCO, Volume 16, Issue 1

15December2020

COVID-19 and Paediatric Inflammatory Bowel Disease

David Wilson, P-ECCO Chair

David Wilson
© ECCO

Since the first reports in Wuhan, China in December 2019, the new coronavirus SARS-CoV-2 has resulted in over 40 million confirmed cases of COVID-19 globally with over 1 million deaths within just 10 months. Economies have been shattered, routine healthcare has been severely disrupted, and restrictions have been imposed on travel and social and family life in a previously unthinkable manner.

Posted in ECCO News, Committee News, Congress News, P-ECCO, Volume 15, Issue 4

30June2020

Microbiome and diet: advances in the pathogenesis and treatment of Crohn’s Disease

Johan Van Limbergen, P-ECCO Member

Johan van Limbergen
© ECCO

Dietary advice in the management of IBD has evolved in recent years from having gastrointestinal symptom reduction as a goal to a more pathogenesis-focussed approach [1–4]. At present, dietary recommendations in adult Crohn’s Disease (CD) are limited to increasing dietary fibre by means of fruit and vegetables and decreasing processed foods [1]. The nutrition debate has long divided adult and paediatric CD care, from international guidelines all the way through to service provision arrangements, with growth failure being a common feature in paediatric CD and dietetic support being a mainstay of care in many children’s hospitals [5–7].  

Posted in ECCO News, Committee News, Congress News, P-ECCO, Volume 15, Issue 2

11October2019

Fighting for growth in paediatric Inflammatory Bowel Disease

Amit Assa, P-ECCO Member

Fighting for growth in paediatric Inflammatory Bowel Disease

Amit Assa1,2

Amit Assa 2019
Amit Assa
© ECCO

Growth retardation is commonly seen in children diagnosed with Inflammatory Bowel Disease (IBD), mainly those with Crohn's Disease (CD). The aetiology of poor growth in children with IBD is multifactorial and includes malnutrition, poor intake, increased nutritional needs, elevated inflammatory cytokines, genetic factors (parental height, CD susceptibility genes) and corticosteroid therapy. Growth retardation may be present years before diagnosis of IBD, and it commonly persists despite disease-specific treatments, with implications for final adult height and consequent social and psychological burden.

Posted in ECCO News, Committee News, P-ECCO, Volume 14, Issue 3

12June2019

Microbiome and diet are partners in CD pathogenesis and treatment

Johan Van Limbergen 2019
Johan Van Limbergen 
© ECCO
Konstantinos Gerasimidis wrc 2015
Konstantinos Gerasimidis
© ECCO

Johan Van Limbergen1,2, Konstantinos Gerasimidis3

Crohn’s Disease (CD) is increasing in incidence worldwide [1]. In spite of increased use of immune suppression, which has markedly changed the need for in-hospital care, paediatric CD remains associated with considerable morbidity as well as increased mortality [2, 3]. The onset of disease in childhood and adolescence often interferes with growth and development, both physically and psychologically. In a subset of patients, the progressive nature of disease may be associated with a fibrotic phenotype that does not respond adequately to the currently available immune suppressive medications, yet use of these medications is still associated with increased risk of myelosuppression, opportunistic infections, immune-mediated phenomena and malignancy [2, 4–6]. 

Posted in ECCO News, Committee News, P-ECCO, Volume 14, Issue 2

30April2019

New Committee Members in P-ECCO

David Wilson, P-ECCO Chair

David WilsonDavid Wilson
© ECCO

The mission of the Paediatric Committee of ECCO is improving knowledge on paediatric-specific IBD issues as well as supporting and facilitating research into paediatric IBD. During the ECCO Congress in Copenhagen, P-ECCO said goodbye to Patrick van Rheenen and Jaroslaw Kierkus. We greatly thanked them for all their contributions to P-ECCO and welcomed two new members: Johan van Limbergen and Amit Assa

Posted in ECCO News, Committee News, Congress News, ECCO'19, P-ECCO, Volume 14, Issue 1