Ulcerative Colitis Clinical Trial
Official title:
IBDSL Biobank Project. Molecular Markers for Diagnosis and Therapy Response in IBD. A Prospective Population Based Biobank of Inflammatory Bowel Disease Patients in Zuid Limburg, The Netherlands.
The IBD South Limburg (IBDSL) project was initially designed as a prospective population
based cohort study. Since 1991, all new IBD cases have been enrolled in the cohort and
prospectively followed. As from 2011, the cohort is being scaled up into a population based
biobank and focus expanded from epidemiology towards exploring underlying biologic
mechanisms and identifying markers to predict disease course or therapy response.
Every adult IBD patient, diagnosed in and permanently residing in South Limburg (The
Netherlands), is eligible to participate. The population based nature was reached via a
multi-faceted approach; incident cases were prospectively identified through the
participating hospitals, and missed patients were retrospectively identified using the
nationwide histopathology registry. In 2011, over 3500 patients were included, which
represents 93% of the IBD population in South Limburg.
The cohort includes baseline data, such as IBD phenotype, extent, location, behaviour, extra
intestinal manifestations, medication, surgery, comorbidity and demographics. Data has
prospectively been updated through chart review (clinical data), questionnaires (i.e.
quality of life) and linkage to the authority database (vital state, residence). The biobank
includes serum, plasma, DNA, faeces, biopsies and exhaled air.
We welcome new collaborations. Applications for collaboration are first to be approved by
our IBD-SL committee.
Background: Inflammatory Bowel Disease (IBD), encompassing Crohn's Disease (CD) and
Ulcerative Colitis (UC), is a chronic disabling condition of the intestine. Most patients
experience sequences of exacerbation in which quality of life is often impaired. Also
society endures heavily, as IBD healthcare costs are estimated at 4.6-5.6 billion euros per
year and high rates of unemployment and work disability are reported. The current incidence
estimate is 256.000 Europeans per year, and yet increases.
IBD arises from complex interactions between a genetically altered intestinal immune
response, environmental factors and intestinal microbiota. Disease phenotypes are
heterogeneous and predicting individual disease course or therapy response is still merely
possible; treatment of choice for instance remains a trial-and-error based succession of
regimens. Further exploration of the underlying biologic mechanisms, and the identification
and validation of non-invasive markers to predict disease course and therapy response are
the foremost challenges in IBD field at this moment.
Deeply phenotyped IBD cohorts with a biobank are ideal tools for this type of research, and
are warranted. Most IBD biobanks reflect hospital based populations thereby over
representing severe and therapy refractory patients. However, many hypotheses require
designs with a full IBD spectrum. Secondly, phenotypes are mostly ascertained
retrospectively, which makes results prone for bias. As no prospective population based
biobank excists, we started the population based IBD South Limburg (IBDSL) biobank project.
IBDSL: The IBDSL project was first established in 1991, when gastroenterologists started
prospectively registering all IBD patients residing in South Limburg, the Netherlands. As
from 2011, this cohort is being scaled up into a biobank and focus expanded from
epidemiology towards exploring underlying biologic mechanisms and identifying markers to
predict disease course or therapy response.
Population: Every adult IBD patient, diagnosed in South Limburg after 1991 and permanently
residing in South Limburg (the Netherlands), is eligible to participate. The population
based nature was reached via a multi-faceted approach; incident cases were prospectively
identified through the participating hospitals, and missed patients were retrospectively
identified using the nationwide histopathology registry. In 2011, over 3500 patients were
included, representing >93% of the IBD population in South Limburg. Adults and partners of
included patients serve as controls.
Datacollection: All eligible IBD patients will be contacted and asked to participate.
Patients will be visited at home or in hospital by a research nurse. After informed consent,
DNA, serum, plasma, exhaled air and stool are collected. All data will be added into a
custommade web-based data management system (MACRO). All biomaterials are stored in the
central biobank facility of the MUMC.
Additional information: IBDSL is a Dutch consortium comprising the gastroenterology
departments of Maastricht University Medical Centre+ and the general district hospitals
Orbis MC Sittard-Geleen and Atrium MC Heerlen. IBDSL is investigator initiated and has been
funded by the consortium members. IBDSL has been approved by the Ethics Committee of the
Maastricht University Medical Centre (METC 10-2-071, NL31636.068.10), and meets the ethical
standards of the declaration of Helsinki. We welcome new collaborations. Applications for
collaboration are first to be approved by our IBD-SL committee.
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Observational Model: Cohort, Time Perspective: Prospective
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