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dy may provide information of high relevance for clinical practice

The research for development of cell therapies for inflammatory bowel diseases

has established the option of autologous hematopoietic stem cell transplantation
as a clinically accepted alternative for treatment of refractory Crohn’s disease,

which has been recognized in the recent guidelines of the European Bone Ma-
rrow Transplant group. Notably, the development process of another form of

cell therapy, based on the administration of autologous conditioned tolerogenic

dendritic cells, obtained from peripheral blood monocytes has been completed,
and the production process has obtained a European patent, in which CIBERehd

has a considerable participation. Furthermore, a phase I clinical trial is actively

recruiting patients and will be completed in 2013.

The majority of groups integrated in the program have provided a significant
contribution in terms of samples and associated high-quality clinical information

for completion of a GWAS in inflammatory bowel diseases. So far, this project

has led to the discovery of new susceptibility locus for Crohn’s disease. This
will be continued by functional characterization of the genetic susceptibility va-

riants. The project will also take advantage of the long prospective follow-up of
patients, which makes this collection unique, to establish robust genotype-phe-

notype associations, overcoming the limitations of previous studies with limited

clinical information associated to the samples.

Studies on the gut microbiota within the European MetaHIT project have de-
veloped novel strategies to detect unknown commensal species using a high-

throughput sequencing and the metagenomic species concept (groups of genes

that co-vary among individuals). This strategy has unveiled a number of com-
mensals that are missing in ulcerative colitis and Crohn’s disease patients.

Collaborations between various groups have also resulted in relevant publica-

tions for development of new therapies for IBD, such as the elucidation of mo-

lecular mechanisms of resistance to corticosteroids, and optimization of current
treatments such as thiopurines and anti-TNF antibodies, to get the maximum

efficiency in the use of these drugs, that impose a significant cost to the public
health system. In this respect, a prominent project is the identification of pre-

dictors of response to anti-TNF therapy, as well as predictors of loss of response.

This is a timely initiative since it is envisiones that in the next few years other
alternative therapies may be approved, and the precise prediction of responose

ot each of the therapeutic options will result in improved patient care and redu-

ced costs.

The microscopic colitis has been considered a rare disease. The collaborative
effort of several groups integrated in the CIBERhed has allowed the identifica-

tion of epidemiological risk factors for the disease. Advances in the diagnosis,
natural history and quality of life of other forms of intestinal inflammation such 13
20
as celiac disease are also under investigation in the setting of CIBERhed.
T
OR
Members of the program 6 have had a high participation and international vi- P
RE
sibility on the elaboration of practice guidelines and consensus documents, in L
various areas including Barrett’s esophagus, management of H. pylori infection, A
NU
upper gastrointestinal bleeding, NSAID-related gastrointestinal complications, N
A
inflammatory bowel disease, microscopic colitis, oropharingeal dysphagia and D /
neurogastroenterology disorders. During 2012, some of the members of the H
E
group have had tenure of presidency of international medical societies or have ER
served as associate editors of first decile journals.
IB
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