Terrence A Barrett
The objective of the current study is to compare non-healing colonic ulcers in patients with inflammatory bowel disease (IBD) with iatrogenic colonic ulcers (biopsy sites) in healthy control patients and patients with rheumatoid or psoriatic arthritis. Patients will be biopsied at baseline and again at a follow-up visit in a "biopsy of the biopsy" approach. These biopsies will be used to reveal patterns about gene expression and mitochondrial function during ulcer healing.
Induction of mucosal healing in inflammatory bowel disease (IBD) is associated with reduced hospitalizations, surgeries, and reduced cancer risk. However, previous studies have shown that 54-69% of ulcerative colitis (UC) patients fail to heal ulcers after several weeks of treatment, and roughly half do not maintain remission at one year. The single most important factor in preventing severe medical consequences, like colon removal surgery or cancer, is treatment to completely heal the top layer of the intestine as quickly as possible. Healing is a complex process and the dysfunction observed…
Inclusion Criteria (Group 1): * Diagnosed ulcerative colitis or Crohn's disease * Biologic failure or naive to biologic treatment * Eligible to be treated with anti-TNF therapy Inclusion Criteria (Group 2): * Diagnosed rheumatoid or psoriatic arthritis * Receiving anti-TNF antibody therapy at the time of enrollment Inclusion Criteria (Group 3): * Endoscopically unremarkable colonic mucosa * Absence of inflammatory bowel disease Exclusion Criteria: * Classified in an anesthesia risk group, ASA Class =4 * History of bleeding diathesis or coagulopathy * Stroke or transient neurological att…
During the initial colonoscopy, 16-20 biopsies will be collected in addition to standard of care biopsies, and biopsy sites will be tattoed. Patients will return for a follow-up colonoscopy 4-35 days later. An additional 16-20 biopsies will be collected in a "biopsy of the biopsy" approach.
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