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IBD Alliance

The IBD Alliance at the Karolinska Institutet/Hospital is a network of physicians and researchers (physicians/non-physicians) interested in IBD. The aim is to promote the interaction between clinical care and research in IBD.

Inflammatory bowel disease (IBD) affects more than 60 000 individuals alone in Sweden. It is generally divided into ulcerative colitis (UC), Crohn’s disease (CD), and unspecified IBD (IBD-U). IBD has undergone major changes over time. While the mortality in the 1950s was 30-40%, new treatment has meant that death is now rare in IBD. Initial treatment was restricted to bowel surgery (especially colectomy), until steroids were introduced and later 5-ASA and thiopurines. Today, IBD is one of the most exciting areas for new treatments. TNF-blockers and other biologics have shown great effect. Also the interplay between microbiota and dietary intake yields promises (the NOD2 mutation plays an important role in Crohn’s disease and recognises bacterial peptides). In children enteral nutrition often has a substantial effect on disease activity, and fecal transplantation is a potential treatment.


The increased survival in IBD means that physicians more and more will have to focus on long-term complications such as colorectal cancer, lymphoma and opportunistic infections. Patients are followed by regular visits to physicians, dieticians, dedicated IBD nurses etc, and IBD-specific diagnostics include fecal calprotectin and endoscopy and increasingly ultrasound and magnetic resonance.


Professor Jonas Ludvigsson is the coordinator of the IBD Alliance network.

Participants

Almer, Sven 

Arnell, Henrik 

Askling, Johan 

Backman, Ann-Sofie 

Bergquist, Annika 

Björk, Jan 

Bresso, Francesca 

Browaldh, Lars 

Casswall, Thomas 

D'Amato, Mauro 

Davidsdóttir, Loa 

Eberhardson, Michael 

Ekbom, Anders 

Finkel, Yigael 

Hedin, Charlotte 

Hultcrantz, Rolf 

Ideström, Maja 

Jonsson-Rolandsdottir, Helena 

Kapraali, Marjo 

Karlsson, Annika 

Kharrazi, Gandom 

Krantz, Åsa 

Lepp, Johanna 

Lindfors, Ulrik 

Lindgren, Fredrik 

Lindström, Lina 

Lördal, Mikael 

Malmborg, Petter 

Mellander, Marie-Rose 

Mjösberg, Jenny 

Mouratidou, Natalia 

Nilsson, Per 

Olen, Ola 

Svensson, Mattias 

Tapsas, Dimitros 

Thulin, Helena 

Törkvist, Leif 

Uusijärvi, Agneta 

Zetterström, Cecilia 

Ongoing projects

 

Ludvigsson, Jonas: network coordinator, KI,Risk of cancer in IBD - a registry-based study. The primary objective is to evaluate the risk of cancer in children and adults with IBD taking disease location, grade of inflammation and treatment into account.

Bresso, Francesca, KI: Role of epigenetic modifications in IBD. To evaluate epigenetic modifications in IBD, causative and regulatory role, related gene-environment interaction and identification of putative biomarkers

-"'--"-Gastromics: Biobank at Gastrocentrum, KS. Build a biobank at gastrocentrum, with collection of data and material, diagnose independent, prospective, possibly linked to registries. Gastromics: multi-omics project based on it.

Eberhardson, Michael, KS. Selective targeting of pro-inflammatory immune cells for the treatment of inflammatory bowel disease: Selective chemokine-based apheresis may represent a safe and valuable addition to current anti-inflammatory therapies. The aim of this research programme is to perform studies of chemokine-loaded leukapheresis column (TLA Gut) in inflammatory bowel disease.

Ekbom, Anders, KI. Chronic inflammation - will it be less harmful after anti-inflammatory therapy? Follow-up of different patient groups with chronic inflammation with regards to morbidity, mortality utilization of health care, following different interventions, including surgery.

Davidsdóttir, Loa, KS. Women and men of fertile age with IBD: fertility, fecundity, pregnancy and delivery in pairs with at least one person has IBD, and follow-up of children born to IBD patients  

Finkel, Yigael, Södersjukhuset. Infliximab - trough levels and disease activity scoring in ped CD  

-"'--"'- Immunological and clinical evaluation of enteral nutrition in remission treatment of newly diagnosed CD  

-"'--"'-Immunological and clinical evaluation of granulocyte-monocyte apheresis for remission treatment in newly diagnosed UC  

Hedin, Charlotte, KS. Altered intestinal microbiota and blood T-cell phenotype are shared by Crohn’s disease patients and their unaffected siblings: This project aimed to delineate the genetic, immune and microbiological profile of CD patients, their siblings and controls and also to determine which factors discriminate groups.

Jonsson-Rolandsdottir, Helena, Södersjukhuset. Serum levels of Infliximab and the effect of treatment in children and youth with IBD  

-"'--"'- Immunologic profile in children and youth who are diagnosed with ulcerus colitis and who are treated with Aferes  

-"'--"'- Immunologic profile in children and youth who are diagnosed with Crohn's disease and are given med Enteral Nutrition treatment  

Kharrazi, Gandom, KS. Outcome of combination therapy in pediatric inflammatory bowel disease: To chart the therapeutic outcome of pediatric IBD

Lindgren, Fredrik, KS. Pancreatic affliction in childhood IBD with or without AILD (Autoimmune Liver Disease): To investigate grade of pancreatic affliction (elevated or decreased pancreatic enzymes, pancreatic exocrine insufficiency and pancreatitis) in other GI-disorders such as IBD and AILD such as AIH and PSC.

-"'--"'- Efficacy and Safety of Adacolumn® Granulocyte, Monocyte/Macrophage Adsorptive (GMA) Apheresis in Children and Adolescents with Moderate Active Ulcerative Colitis (the ADAPT study): To report efficacy and safety results for Adacolumn® Granulocyte, Monocyte/Macrophage Adsorptive (GMA) Apheresis seen in adult UC patients since over a decade are comparable to a pediatric UC population, and whether there were any additional specific risks in pediatric UC patients when treated with Adacolumn.

Lindström, Lina, KS. Recurrence of PSC after liver transplantation: The aim of the study is to identify/confirm risk factors for recurrent PSC in a large and well characterized cohort of PSC patients. Emphasis on IBD-related risk factors such as inflammatory activity and colectomy.

Malmborg, Petter, KS. Prognosis of pediatric IBD: Some studies suggest that childhood-onset of disease represents a more aggressive phenotype of IBD. We are studying the presentation and progression of patients diagnosed with IBD during childhood in a population-based cohort from northern Stockholm County 1990-2007.

Nilsson, Per, KS. Studies on colectomized IBD patients: Mortality, reconstruction rate and patency of reconstruction in a 10-year cohort of operated IBD-patients

-"'--"'- Surgical outcomes in Swibreg Early project - exploratory studies

Olén, Ola, KI. Etiology of Inflammatory bowel disease  

-"'--"'- Prognosis of Inflammatory bowel disease  

Svensson, Mattias, KS. Exploration of stromal cell and neutrophil interactions contributing to the pathogenesis of inflammatory bowel disease: We aim to increase the knowledge of how tissue inflammation persists and how treatment and management of IBD patients can be improved. We will on the one hand investigate how stromal cells affect neutrophils, and on the other hand how neutrophils affect stromal cells to perpetuate inflammation and contribute to IBD pathogenesis.

Uusijärvi, Agneta, KI. A Long-Term Non-Interventional Registry to Assess Safety and Effectiveness of HUMIRA® (Adalimumab) in Pediatric Patients with Moderately to Severely Active Crohn’s Disease: The main aim is to evaluate long-term safety of Humira® in pediatric patients with moderately to severely active CD who are prescribed and treated in accordance with the approved local Humira® product label under the conditions of routine clinical setting. Patients being prescribed and treated with conventional immunosuppressant therapy with no concurrent biologic use will also be enrolled as a reference group.

Selected publications

Family studies in Crohn's disease: new horizons in understanding disease pathogenesis, risk and prevention.
Hedin CR, Stagg AJ, Whelan K, Lindsay JO
Gut 2012 Feb;61(2):311-8

Altered intestinal microbiota and blood T cell phenotype are shared by patients with Crohn's disease and their unaffected siblings.
Hedin CR, McCarthy NE, Louis P, Farquharson FM, McCartney S, Taylor K, et al
Gut 2014 Oct;63(10):1578-86

Patients with ulcerative colitis miss more days of work than the general population, even following colectomy.
Neovius M, Arkema EV, Blomqvist P, Ekbom A, Smedby KE
Gastroenterology 2013 Mar;144(3):536-43

Mortality after total colectomy in 3084 patients with inflammatory bowel disease: a population-based cohort study.
Nordenvall C, Ekbom A, Bottai M, Smedby KE, Nilsson PJ
Aliment. Pharmacol. Ther. 2014 Aug;40(3):280-7'

Birth outcomes in women with inflammatory bowel disease: effects of disease activity and drug exposure.
Bröms G, Granath F, Linder M, Stephansson O, Elmberg M, Kieler H
Inflamm. Bowel Dis. 2014 Jun;20(6):1091-8

Nationwide prevalence of inflammatory bowel disease in Sweden: a population-based register study.
Büsch K, Ludvigsson JF, Ekström-Smedby K, Ekbom A, Askling J, Neovius M
Aliment. Pharmacol. Ther. 2014 Jan;39(1):57-68

Complications from inflammatory bowel disease during pregnancy and delivery.
Bröms G, Granath F, Linder M, Stephansson O, Elmberg M, Kieler H
Clin. Gastroenterol. Hepatol. 2012 Nov;10(11):1246-52

Increasing incidence of paediatric inflammatory bowel disease in northern Stockholm County, 2002-2007.
Malmborg P, Grahnquist L, Lindholm J, Montgomery S, Hildebrand H
J. Pediatr. Gastroenterol. Nutr. 2013 Jul;57(1):29-34

Cesarean section and the risk of pediatric Crohn's disease.
Malmborg P, Bahmanyar S, Grahnquist L, Hildebrand H, Montgomery S
Inflamm. Bowel Dis. 2012 Apr;18(4):703-8

Early-life exposures associated with antibiotic use and risk of subsequent Crohn's disease.
Hildebrand H, Malmborg P, Askling J, Ekbom A, Montgomery SM
Scand. J. Gastroenterol. 2008 Aug;43(8):961-6

Treatment of inflammatory bowel disease by chemokine receptor-targeted leukapheresis.
Eberhardson M, Marits P, Jones M, Jones P, Karlen P, Karlsson M, et al
Clin. Immunol. 2013 Oct;149(1):73-82

HLA-DR(hi) and CCR9 Define a Pro-Inflammatory Monocyte Subset in IBD.
Linton L, Karlsson M, Grundström J, Hjalmarsson E, Lindberg A, Lindh E, et al
Clin Transl Gastroenterol 2012 Dec;3():e29

Colorectal neoplasia in patients with primary sclerosing cholangitis undergoing liver transplantation: a Nordic multicenter study.
Jørgensen KK, Lindström L, Cvancarova M, Castedal M, Friman S, Schrumpf E, et al
Scand. J. Gastroenterol. 2012 Sep;47(8-9):1021-9

Immunosuppression after liver transplantation for primary sclerosing cholangitis influences activity of inflammatory bowel disease.
Jørgensen KK, Lindström L, Cvancarova M, Karlsen TH, Castedal M, Friman S, et al
Clin. Gastroenterol. Hepatol. 2013 May;11(5):517-23

Mortality after total colectomy in 3084 patients with inflammatory bowel disease: a population-based cohort study.
Nordenvall C, Ekbom A, Bottai M, Smedby KE, Nilsson PJ
Aliment. Pharmacol. Ther. 2014 Aug;40(3):280-7