A Proposal for a Study on Treatment Selection and Lifestyle Recommendations in Chronic Inflammatory Diseases: A Danish Multidisciplinary Collaboration on Prognostic Factors and Personalised Medicine

Abstract

Chronic inflammatory diseases (CIDs), including Crohn’s disease and ulcerative colitis (inflammatory bowel diseases, IBD), rheumatoid arthritis, psoriasis, psoriatic arthritis, spondyloarthritides, hidradenitis suppurativa, and immune-mediated uveitis, are treated with biologics targeting the pro-inflammatory molecule tumour necrosis factor-α (TNF) (i.e., TNF inhibitors). Approximately one-third of the patients do not respond to the treatment. Genetics and lifestyle may affect the treatment results. The aims of this multidisciplinary collaboration are to identify (1) molecular signatures of prognostic value to help tailor treatment decisions to an individual likely to initiate TNF inhibitor therapy, followed by (2) lifestyle factors that support achievement of optimised treatment outcome. This report describes the establishment of a cohort that aims to obtain this information. Clinical data including lifestyle and treatment response and biological specimens (blood, faeces, urine, and, in IBD patients, intestinal biopsies) are sampled prior to and while on TNF inhibitor therapy. Both hypothesis-driven and data-driven analyses will be performed according to pre-specified protocols including pathway analyses resulting from candidate gene expression analyses and global approaches (e.g., metabolomics, metagenomics, proteomics). The final purpose is to improve the lives of patients suffering from CIDs, by providing tools facilitating treatment selection and dietary recommendations likely to improve the clinical outcome.

The role of dietary factors in inflammatory bowel diseases: New perspectives

“…But evidences from human studies are scarce. Both null and positive associations were reported by previous studies …”

“…We cannot exclude the possibilities of harmful effects of food additives on IBD, although the relevant human data are deficient. Several prospective cohorts have been conducted to figure out the underlying relationship.…”

Hospital Microbiomics: Benchmarking from the First Longitudinal Study of Microbiome Dynamics among Patient, Staff and Hospital Habitats

“…[21][22][23][24] With increased application of any method there comes a growing role for some form of standardization. Microbiomics methods are now supporting research, development, and clinical studies of traditional and new treatments including personalized medicine, [25][26][27] as well as an expanding list of non-medical areas of research and commerce, such as oceanography, agriculture, soil sciences and plant pathology to list but a few examples. [28][29][30] The application and impact of microbiomics is increasing rapidly.…”

Dietary habits in Japanese patients with psoriasis and psoriatic arthritis: Low intake of meat in psoriasis and high intake of vitamin A in psoriatic arthritis

“…Saturated fatty acid (SFA), rich in meat or butter, exacerbates psoriasis by promoting Th1/Th17 differentiation through activation of dendritic cells . The intake of dietary sulfur rich in red meat may generate hydrogen sulfide rendering the intestinal mucous layer penetrable to bacteria which reach the epithelium and activate Toll‐like receptors and the nuclear factor‐κB inflammatory pathway . In contrast, n ‐3 polyunsaturated fatty acids (PUFA) like eicosapentaenoic acid and docosahexaenoic acid rich in fish are metabolized into resolvin E1 and D1, respectively, which resolve inflammation associated with psoriasis .…”

“…Isoflavones rich in soybean, a representative pulse, suppress hyperproliferation of keratinocytes or production of inflammatory cytokines like tumor necrosis factor (TNF)‐α, interleukin (IL)‐1β, IL‐6 or IL‐8 in endothelial cells . Thus, the intake of fish containing n ‐3 PUFA and soybean containing isoflavones, and minimizing the consumption of red meat containing SFA and dietary sulfur, are recommended to improve psoriasis . The supplementation of vitamin D or vitamin B 12 is also encouraged for psoriatic patients .…”