Inflammatory bowel disease

Problem

Crohn's disease and ulcerative colitis are diseases that begin in childhood and youth and become chronic. They cause a marked deterioration in quality of life for patients, in all spheres. The fact that patients present few specific symptoms (diarrhoea or abdominal pain) leads to a significant delay in establishing a diagnosis and also hinders control.

In recent years, new treatments are being developed, but they are only effective for a certain percentage of patients, and there are no tools able to predict the response.

Approach

The group has developed the methodology to accurately assess the activity, extent and severity of Crohn's disease by means of magnetic resonance, as an alternative to colonoscopy.

The laboratory is an international reference point in translational research aimed at finding out the molecular and cellular mechanisms involved in the development and course of Crohn's disease and ulcerative colitis. It uses techniques such as transcriptional analysis in human samples (determining the genes that are being regulated at all times), analysis of immune cells and their responses to different stimuli or therapies, and the culture of stem cells from the intestinal epithelium. These cultures allow it to study the impact of the disease on different epithelial functions, such as the response to the intestinal microbiota.

The group has introduced highly effective cell therapies for cases in which the body does not respond (such as the use of mesenchymal cells for the treatment of perianal fistulas) and the transplantation of progenitor cells in patients with severe Crohn's disease who cannot undergo surgery.

Impact

The magnetic resonance index for the evaluation of Crohn's disease developed by the group is currently the most commonly used, in both clinical trials and in regular clinical practice.

The group has identified biomarkers linked to disease remission and alternative therapeutic targets for patients who do not respond to current treatments.

In Crohn's disease, it has discovered the presence of immune responses directed against components of the intestinal microbiota and has studied therapeutic options. The group has revealed the deregulation of the epithelial barrier in ulcerative colitis that affects stem cells (progenitors of the entire intestinal wall), which makes them a potential new therapeutic target.

The group has improved many aspects of the safety of transplantation of hematopoietic progenitors making this procedure more acceptable and generalized.

The group is working to optimise the use of mesenchymal cells (a type of stem cell) for the treatment of perianal fistulas, after demonstrating that with a single application, half of the fistulising lesions are cured.