Session 1: IBD
(Sun 08:30 – 10:00 Central A)
Presentation Title: MSUC – How to optimize outcomes in ulcerative colitis
08:50 – 09:10
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Session 3: State of the Art - Colonic IBD – What’s in a Name – Phenotypes/Genotypes/Immunology
(Sun 13:30 – 15:30 Arena 1B)
Presentation Title: Phenotype/Genotype in colonic IBD – What’s in a name?
14:00 – 14:30
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Session 4: Clinical Free Papers Session
(Sun 16:00 – 17:30 Central A) Chairing Session
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Session: IBD and Pregnancy – Trials and Tribulations
(Tue 10:30 – 12:30 Central A)
A Case Based Panel Discussion of IBD and Pregnancy
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Professor Subrata Ghosh
MD(Edin.), FRCP, FRCPE, FRCP, FRCPC, FCAHS
Subrata Ghosh is the Director of the Institute of Translational Medicine and Professor of Translational Medicine, University of Birmingham. He took up this position on the 1st of June 2016. He moved from Canada where he was the Professor of Medicine at University of Calgary. He was cross-appointed as Professor of Immunology and microbiology and was an adjunct Professor in the department of veterinary medicine. He was the Head of the Department of Medicine at Cumming School of Medicine, University of Calgary and the Zone Clinical Department Head, Calgary Zone, Alberta Health Services. Previously, he was the Chair of Gastroenterology and Professor of Gastroenterology at the Imperial College London, Hammersmith Hospital and associate professor of gastroenterology at University of Edinburgh. Dr Ghosh is a Fellow of the Canadian Academy of Health Sciences and a member of the International Organization for the Study of IBD. He is a past editor in chief of the Canadian Journal of Gastroenterology and Hepatology and associate editor of Gut, and sits on the editorial boards of several journals. He served on the Scientific Advisory Committee of the Crohn’s and Colitis Canada and Chaired its of Advocacy Committee and he was the chairman of the medical advisors of the Crohn’s and Colitis UK. Dr Ghosh has published over 398 manuscripts. He has delivered over 600 international lectures. His research interests are focused on translational immunology of inflammatory bowel disease and novel therapeutic approaches.
Significant contributions (Current h index 61, citations 14,500; Publications 398)
1. Ghosh S, Goldin E, Gordon F, Malchow HA, Rask-Madsen J, Rutgeerts P, Vyhnalek P, Zadarova Z, Palmer T, Donoghue S. Natalizumab for active Crohn’s disease. N Engl J Med 2003; 348:24-32. (736 citations, accompanying editorial). This article was the first randomized controlled trial that provided evidence that inhibition of integrins was effective as a therapeutic target in inflammatory bowel disease.
2. Sandborn WJ, Ghosh S, Panes J, Vranic I, Su C, Rousell S, Niezychowski W. Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis. N Engl J Med 2012;367: 616-624. (239 citations). This article was the first randomized controlled trial that provided evidence that inhibition of JAK was effective as a therapeutic target in inflammatory bowel disease.
3. Shmakov AN, McLennan NF, McBride P, Farquhar CF, Bode J, Rennison KA, Ghosh S. Cellular prion protein is expressed in the human enteric nervous system. Nature Medicine 2000;6 :840-841. (41 citations). This article provided evidence for a route of intestinal transmission of infectious prion protein in variant Creutzfeldt Jakob disease. The entire field of interaction of infectious prion protein with the intestine was critically assessed in an invited review (Gut 2001; 48: 443-447).
4. Akbar A, Yiangou Y, Facer P, Walters JR, Anand P, Ghosh S. Increased capsaicin receptor TRPV1 expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain. Gut 2008; 57:923-929. (287 citations, accompanying editorial). This showed the involvement of TRPV1 in visceral hypersensitivity of irritable bowel syndrome, the commonest gastrointestinal disorder. This is now potentially a therapeutic target.
5. Van Heel DA, Ghosh S, Butler M, Hunt KA, Lundberg A, Ahmad T, McGovern DPB, Onnie C, Negoro K, Goldthorpe S, Foxwell BMJ, Mathew CG, Forbes A, Jewell DP, Playford RJ. Muramyl dipeptide and toll-like receptor sensitivity in NOD2 associated Crohn’s disease. Lancet 2005;365: 1794-1796. (274 citations, accompanying editorial). This was the first study to show that NOD2 mutations, the first mutations associated with Crohn’s disease, are loss of function in human inflammatory bowel disease and suggested how this may relate to intestinal inflammation.
6. Ghosh S, Cowen S, Hannan WJ, Ferguson A. Low bone mineral density in Crohn’s disease but not in ulcerative colitis, at diagnosis. Gastroenterology 1994;107: 1031-1039. (259 citations). This article established for the first time that osteopenia in inflammatory bowel disease may be driven by inflammation directly, rather than only as a consequence of steroid therapy. Strategies for prevention of osteopenia cite this manuscript frequently.
7. van Heel DA, Ghosh S, Hunt K, Mathew C, Forbes A, Jewell D, Playford R. Synergy between TLR9 and NOD2 innate immune responses is lost in genetic Crohn’s disease. Gut 2005; 54: 1553-1557. (120 citations). Further evidence of loss of function of NOD2 mutation in human inflammatory bowel disease and relationship with intestinal inflammation. This is now a therapeutic target.
8. Akbar A, Yiangou Y, Facer P, Walters JRF, Brydon WG, Anand P, Ghosh S. Expression of the TRPV1 receptor differs in quiescent inflammatory bowel disease with or without abdominal pain. Gut 2010;59: 767-774. (64 citations) This studied provided an explanation for visceral hypersensitivity in patients with quiescent inflammatory bowel disease who continued to suffer from pain, a common problem which causes significant morbidity.
9. Marion R, Butler M, Dechelotte P, Playford R, Ghosh S. Comparison of cytokine modulation by natural PPAR gamma ligands with synthetic ligands in intestinal-like Caco-2 cells – potential for dietary modulation of PPAR in intestinal inflammation. Am J Clin Nutr 2008;87: 939-948.(56 citations) This study provided a mechanistic explanation for a target for dietary fatty acid modulation of inflammation in inflammatory bowel disease. We published an invited review on the topic summarizing all the research work (Gut 2009; 58: 586-593).
10. Butler M, ChiYan Ng, Van Heel D, Lombardi G, Lechler R, Playford RJ, Ghosh S. Modulation of dendritic cell phenotype and function in an in vitro model of the intestinal epithelium. Eur J Immunol 2006; 36: 864-874. (61 citations) In this study we provided evidence that the tolerogenic phenotype of dendritic cells in the intestine may be modulated by close contact with intestinal epithelial cells in an in vitro model. We published an invited review on the mechanisms of tolerization of dendritic cells in the intestine (Gut 2009; 58: 1291-99).
11. Van Heel DA, Ghosh S, Butler M, Hunt K, Foxwell BMJ, Mengin-Lecreulx D, Playford RJ. Synergistic enhancement of Toll-like receptor responses by NOD1 activation. Eur J Immunology 2005; 35: 2471-2476. (121 citations) In this study we demonstrated how TLR and NOD1 activation act synergistically to promote inflammation.
12. Shmakov A, Bode J, Kilshaw P, Ghosh S. Diverse expression of 67kD laminin receptor protein in human small intestine. J Pathol 2000; 191:318-322. (51 citations) In this study we provided evidence for potential transmission pathways for infectious prion protein via the intestine.
13. Armitage EL, Aldhous MC, Anderson N, Drummond HE, Riemersma RA, Ghosh S, Satsangi J. Incidence of juvenile-onset Crohn’s disease in Scotland: Association with northern latitude and affluence. Gastroenterology 2004; 127: 1067-1075. (134 citations) I supervised my graduate student Emma Armitage for her doctorate of medicine thesis and I was the principal investigator for the MRC grant funding this study – it showed that deprivation as social status is protective for Crohn’s disease.
14. Vermiere S, Ghosh S, Panes J, Dahlerup J, Luegering A, Sirotiakova J, Strauch U, Burgess G, Spanton J, Martin S, Niezychowski W. The mucosal Addressin Cell Adhesion Molecule (MAdCAM) Antibody PF-00547, 659 in ulcerative colitis: a randomized study. Gut 2011; 60: 1068-1075. (51 citations) We showed in a randomized controlled trial that in addition to inhibition of integrins, inhibition of its ligand MAdCAM-1 was also effective as an anti-inflammatory agent in ulcerative colitis – these work led to introduction of anti-adhesion molecules as therapeutic agents in IBD.
15. Panaccione R, Ghosh S, Middleton S, Marquez JR, Scott BB, Flint L, van Hoogstraten HJF, Chen AC, Zhen H, Danese S, Rutgeerts P. Combination treatment with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis. Gastroenterology 2014; 146:392-400. (130 citations) I designed the study and analyzed the data which showed that a combination of anti-TNF monoclonal antibody and azathioprine is superior to either agent alone.
16. Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G, Benchimol EI, Panaccione R, Ghosh S, Barkema HW, Kaplan GG. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 2012;142:46-54. Highly cited definitive article on incidence and prevalence of IBD globally. (1167 citations)
17. Levesque BG, Ghosh S. Targeting Integrins and Safety in an Emerging Class of Targeted Oral Therapies: Are We Prepared for Rational and Precision Choices? Gastroenterology. 2015;149:1669-72. This was an invited state of the art editorial/commentary.
18. Ghosh S, Daperno M. Topical therapy in ulcerative colitis: always a bridesmaid but never a bride. Gastroenterology 2015; 148:701-704. This was an invited state of the art commentary.
19. Sandborn WJ, Feagan BG, Wolf DC, D’Haens G, Vermeire S, Hanauer SB, Ghosh S, Smith H, Cravets M, Frohna PA, Aranda R, Gujrathi S, Olson A; TOUCHSTONE Study Group. Ozanimod Induction and Maintenance Treatment for Ulcerative Colitis. N Engl J Med. 2016;374: 1754-62.
20. Ghosh S, D’Haens G. Is an Ounce of Prevention Worth a Pound of Cure: Postoperative Recurrence of Crohn’s Disease? Gastroenterology. 2016 Apr 29. pii: S0016-5085(16)34337-2. (ePub ahead of print)