CD-1: Individual Management – Prospective Cohorts from the CCIM for Definition of Disease Control

Coordinators: S. Schreiber (CAU), D. Thaçi (UzL), S. Weidinger (CAU)

In CD-1 a large, structured, prospective patient cohort is being established. The aim is to gain a better and more comprehensive understanding of the mechanism of targeted treatments for chronic inflammatory bowel disease, psoriasis and psoriasis arthritis, and to identify new biomarkers that can be used as therapeutic endpoints. The concept is that of a non-interventional study to characterize disease progressions under targeted treatment and to find biomarkers. The aim is a better control of long term progression. This will take place based on detailed characterization of patients with chronic inflammatory barrier diseases (CIBD), who will be examined and characterized in the CCIMs as synchronized as possible making maximum use of the treatment standards. Broad consent is essential here. It allows to use biomaterials remaining from diagnostics and to add it to the biobanks of the cluster and the clinical data to be transferred from the clinic information system to a research database.

Chronic inflammatory barrier diseases often lead to structural changes and a lasting loss of function in patients. New, targeted treatments have significantly improved the treatment of chronic inflammatory diseases. However, complete control of the disease activity can only be achieved in a fraction of the patient population. A considerable disadvantage in the use of targeted treatments and biologicals is the lack of comparative assessments of the effectiveness of different treatments and the lack of indicatory objective markers that are able to predict individual disease progressions including precise assessments of the disease activity. The ultimate goal in the treatment of chronic inflammatory diseases is complete disease control that contains clinical remission, normal bodily function as well as the avoidance of side effects, complications, and comorbidities.

The main focus is to identify molecular markers to control targeted treatments in chronic inflammatory barrier diseases like morbus crohn, colitis ulcerosa, psoriasis vulgaris, and psoriasis arthritis as well as atopic dermatitis. At molecular level, the treatment response, long-term effect and loss of effect of biologicals are to be defined. Furthermore, early molecular markers are to be identified for predicting the response to the treatment with various targeted treatments. In addition, the members establish complementary technologies such as imaging (including optical coherence tomography or open microperfusion) in order to improve diagnosis and the determination of treatment success in chronic inflammatory barrier diseases.

The close cooperation of the medical disciplines of gastroenterology, dermatology and rheumatology within the CCIMs and the cluster enables a diversity of expertise regarding the different pathophysiological mechanisms involved in chronic inflammatory barrier diseases. This enables an interdisciplinary treatment strategy. By working together to construct a prospective patient cohort, an excellent characterization of a large number of patients with a variety of diseases and treatments can be achieved. Patients will directly benefit from the identification of biomarkers for predicting disease activity, possible side effects and the expected clinical response to treatment. The clinical areas of the CCIM are closely connected to the molecular research areas of the cluster, so that biomaterials and clinical data can be exchanged.

With large BMBF projects (e.g. eMed TRY IBD, GUIDE IBD) and EU IMI projects (e.g. Biomap, 3TR/Priorize IBD and Immuniverse), CD-1 has involved partners from industry and thereby obtained considerable additional funding, which is necessary to operate these agendas.

Individual treatment decisions for inflammatory diseases can only be made and optimized if molecular and cellular changes are detected at an early stage of disease progression and treatment. The research area CD-1 therefore clearly contributes to treatment management and the prediction of response to treatment in the context of precision medicine.

There is a close cooperation of CD-1 in the structured characterization of the patient cohorts and the analysis of the biomaterials with RTF I, II, III, VI, VII, VIII, IX, X. Furthermore, cooperation exists with TI-1, CD-2, CD-4 and CD-5.

What does this research area's work build on?

What are the main research objectives?

What makes this research area special?

What does the research area contribute to precision medicine in chronic inflammation?

Cooperation with other research areas in the cluster

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