Crohn’s disease is a moving target. It can affect any part of the gastrointestinal tract, its severity waxing and waning through the years. The precise cause of this devastating inflammatory bowel disease is still unknown.
Unpredictable and incurable, Crohn’s varies with each person. When diagnosed — usually between the ages of 15 and 35 — it means a lifetime of ongoing treatment. Drugs can stabilize the disease, helping to regulate an overactive immune system. But for some patients, Crohn’s disease will continue on its destructive path, causing progressive bowel damage.
“That’s because the disease location and behavior can vary over time for each person,” said Peng Qiu, associate professor in the Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia Tech. “Most research in Crohn’s disease is still being carried out by investigating one single biopsy from a single time point.”
This snapshot-in-time approach just isn’t cutting it. So Qiu is leading a team of multidisciplinary researchers on a deeper dive into the assessment and tracking of Crohn’s. Ultimately, Qiu hopes their work will lead to personalized treatment strategies and better outcomes for patients.
To help him in that quest, The Leona M. and Harry B. Helmsley Charitable Trust has granted Georgia Tech $2.8 million over three years to pilot new technologies for a greater understanding of cellular behavior in Crohn’s disease.
The project is part of the Gut Cell Atlas initiative, supported by Helmsley, which aims to understand distinct cell functions and interactions in human health and, specifically, Crohn’s disease. It is also part of a larger international effort to map all cells in the human body called the Human Cell Atlas.
“The Gut Cell Atlas, as well as the Human Cell Atlas, are at the forefront of scientific research, as we try to understand complex biological systems by examining the activities and interactions of large numbers of individual cells,” said Qiu, principal investigator of the Helmsley-funded project called “Longitudinal tracking and reference-based interpretation of single-cell characteristics in treatment-naïve patients with Crohn’s disease.”
His collaborators are co-principal investigators Subra Kugathasan, physician and inflammatory disease researcher at Emory and Children’s Healthcare of Atlanta, and Greg Gibson, professor in the School of Biological Sciences and director of the Center of Integrative Genomics at Georgia Tech.
Together, they’ll expand the scope of Crohn’s research, taking it beyond that single time point. They’re working under the hypothesis that an evaluation of 50 newly diagnosed pediatric patients who have never undergone treatment for their illness, across several time points, will lead to a comprehensive understanding of the Crohn’s disease landscape.
They plan a quantitative analysis of each patient, generating single-cell RNA-sequencing data — first, to set a baseline at initial diagnosis, then again once or twice over the next three years. They’ll also compare the baseline data with down-the-road treatment outcomes, searching for specialized cell populations and gene expression signals that can predict how patients respond to, or resist, treatment.
“Longitudinal studies at such a single-cell level will provide deeper understanding and lead to new ideas for disease prevention and treatments,” Qiu said. “If we’re successful, those cell populations and genes will be useful for developing hypotheses for personalized treatment, and ultimately, improving patients’ qualify of life.”