IBD Research team at Our Lady’s Childrens Hospital Crumlin
Download the paper to get involved with current research The GEM Project in conjunction with Mount Sinai Hospital in Canada, the UK and USA.
GEM research information download
Diet and Microbes at the Extremes of Life-UCC Research
Thank you Hazel for your contribution…
The interplay between diet, the microbiota and health at the extremes of life, infants and older subjects, is the main topic of this research theme, with a unifying emphasis on nutrition, cognition and inflammatory disease…
Click here for more information
The History of Probiotics
This link was sent to me from Annabel Grey,
with the renewed interest in antibiotics v’s probiotics it’s an interesting read.
An abstract from PubMed on the dangers of probiotics on an immunocompromised child
“Probiotic strains of Lactobacillus are currently used in a variety of clinical practices with limited evidence to support their use. Lactobacillus species are a normal part of gastrointestinal flora, and bacteremia with probiotic strains of Lactobacillus is very uncommon. We describe a case of Lactobacillus bacteremia in a 17-year-old boy with ulcerative colitis managed with systemic corticosteroids and infliximab, who presented with fever to 102°F, flushing, and chills 1 week after starting Lactobacillus rhamnosus GG probiotics.
Initial blood culture on day 2 of his fever was positive for Lactobacillus, however, subsequent blood cultures on day 3 and 5 were negative. He was treated empirically with antibiotics for 5 days and defervesced by day 8 of his illness. 16 S rRNA sequence analysis identified the organism from the patient’s blood culture and probiotic capsule as L. rhamnosus with a 99.78% match for both the strains. This case report highlights the potential risk of Lactobacillus bacteremia in immunosuppressed patients with severe active ulcerative colitis.
Lisa Richards comment on the abstract above…
“There have been many promising studies on probiotics in children, particularly among those who are taking antibiotics. For example, repeated studies have shown that probiotics reduce the diarrhea associated with children’s antibiotic use. There is also evidence that acute diarrhea (i.e. diarrhea not associated with antibiotics) can be improved by taking probiotics. Other studies have shown probiotics can reduce children’s eczema and decrease the incidence of respiratory infections. A set of smaller studies has shown that probiotics may have the potential to reduce colic, treat chronic ulcerative colitis and treat H Pylori, although more research is needed in these areas.
Probiotics are generally safe and can be a very useful addition to a treatment regimen, but we still need to exercise some caution when giving them to our children. This applies particularly to those who have an extremely weak immune system or who have medical devices like catheters. There have been isolated examples of immunocompromised adults and children becoming ill from septis after taking probiotic supplements, although in most instances the offending microorganism was found to have come from the patient’s own gut flora. Even though the risks are small, if a child is immunocompromised then he or she should not be given probiotic supplements. That’s why its usually best to consult your medical professional before you start your child on probiotic supplements.”
Merck Millipore published research information Vol 1 2013-NF-κB Activation:
…Link Between Chronic Inflammation and Cancer
NF-κB Activation: A Molecular Link Between Chronic Inflammation and Cancer
The NF-κB signal transduction network is shown to be dysregulated in a variety of human cancers, especially those of lymphoid cell origin. Plus, certain natural products with anticancer activity, such as cucurmin and kava, may be acting by blocking the NFκB pathway, which is activated during the inflammatory response.
Read our new research focus to learn all about the NF-κB pathway…
Paediatric IBD Research in Ireland 2013~ Dr. Aoife Carey
There has been a substantial and sustained increase in the incidence of childhood UC and
CD in Ireland over a relatively short period of time. Research plays an integral role in
understanding why this is happening. Our Lady’s Children’s Hospital, Crumlin (OLCHC) is at
the forefront of clinical IBD research under the direction of Dr. Seamus Hussey and research
coordinator Dr. Aoife Carey. Through on-going research we aim to find ways of identifying
the causes of paediatric inflammatory bowel disease (IBD), improving how we diagnose IBD
and attempt to better predict treatment and long term outcomes. All research in children
must be pre-approved by the hospital research ethics committee following rigorous
analysis. Our research has been presented at the European Crohns and Colitis Organisation
Conference 2013 (Vienna; Distinction Award) and the Irish Society of Gastroenterology
Meeting 2013 (Belfast; Prize winner). All children newly diagnosed with IBD at OLCHC will be
asked to participate in the following research depending on their diagnosis. Thank you to all
our participating patients and families to date and please continue to support IBD research
projects into the future!
DOCHAS study
Determinants and Outcomes in Children and Adolescents with
IBD (DOCHAS) is a prospective study following all Irish children
who have been newly diagnosed with IBD since 2012. The aim of
this study is to determine the different factors which may
influence the development of paediatric IBD. This translational
research initiative encompasses integrated epidemiological,
clinical, genetic, microbial and laboratory-based research.
Preliminary results have shown changes in the severity and
disease behaviour of IBD in Irish children, with the prevalence of
ulcerative colitis tripling in 10 years. All children diagnosed with
IBD from 2012 onwards will be asked to participate in this study.
To date we have recruited over 130 participants.
iNEOPICS study
The interNational Early Onset Paediatric IBD Cohort Study
(iNEOPICS) is a worldwide multicentre study which aims to
identify and investigate the causes of very early onset IBD,
particularly in infants and very young children. All children
diagnosed with IBD under 10 years of age will be invited to
participate in this study. This study links IBD clinical subtype and
genetic analysis. To date we have recruited 20 patients.
GROWTH study
The GROWTH study, led by the Shaare Zedek Medical Center in Israel, commenced at
OLCHC in 2012 and recruitment ran until December 2012. This prospective multi-center
European study evaluates the risk factors and interactions that could affect disease
recurrence or disease complications in children with new-onset, treatment naive Crohns
disease. OLCHC was one of the largest contributing centres to this study in Europe, with 24
participants. Follow-up of patients will continue for another year. Please remember to bring
in your stool samples!
TUMMY study
The TUMMY study is a 2 stage study for children with ulcerative colitis (UC). Many doctors
and nurses use a screening index called the PUCAI index in order to objectively assess
disease activity in patients with UC. The aim of this study is to adapt the PUCAI index to
become a Patient Reported Outcome (PRO) which would allow it to be completed by
children and/or their parents to evaluate their disease activity over time. This new index will
be known as the TUMMY index. In turn, it is envisioned that the adapted PUCAI could be
used in future UC clinical studies.
Paediatric IBD Cancer and mortality study
In 2013, the first international prospective study of cancer and mortality outcomes in
patients diagnosed with IBD in childhood was launched. Research of this level is necessary
but has been lacking to date. While the subject matter may seem uncomfortable, this study
will hopefully provide robust answers to the very questions that trouble patients, parents
and IBD care providers.
For further information regarding IBD research at OLCHC please contact Dr. Aoife Carey on
01-4092639.
