Inflammatory Bowel Disease (IBD)-A Textbook Case for Multi-Centric Banking of Human Biological Materials

Abstract

Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory condition affecting mainly the gastro-intestinal tract with two main entities: Crohn's disease (CD) and ulcerative colitis (UC). Although the exact mechanisms underlying the initial development of IBD are not fully understood, it is believed that an abnormal immune response is elicited against the intestinal microbiota in genetically predisposed individuals. Crucial elements of the etiopathogenesis have been elucidated by research using human biological materials. The estimated prevalence of IBD is 0.5% in the Western world. Although incidence rates are increasing, both conditions are not "common" in general terms mandating a multicentric approach. Biological material from numerous Belgian patients have been collected over time in a number of university hospitals in Belgium (UH Ghent: 800 CD patients, 350 UC patients, 600 normal controls; UH Leuven: 2,600 CD patients, 1,380 UC patients, 98 IC/IBDU patients, 6,260 normal controls). Within the setting of the Flemish Center Medical Innovation (CMI) initiative and later on the Flemish biobank network a prospective study was set-up across three Belgian IBD centers (University Hospitals Brussels, Ghent, and Leuven). Human biological materials and data have been collected prospectively from newly diagnosed CD and UC patients. The analyses hereof have generated new insights which have been published in the most renowned journals. The approach of well-thought off, multi-centric, structured, and systematic biobanking has proven to be a success-story and thus a textbook case for multi-centric banking of human biological materials. This story is being told in this article.

Keywords: BBMRI.be; BBMRI.nl; Crohn's disease; PSI; biobank; inflammatory bowel disease; ulcerative colitis.

Figure 1

(A,B) Impact of biobanking initiative on samples used in research projects (in function of time) and initiating publication. (A) Shows the number of samples of human biological material used during 1 year (2013 blue, 2014 orange, 2015 gray). The figure demonstrates a clear increase in the use of samples over time which correlates with the activities in the biobank but also and more importantly with the output in publications (B). (B) Shows the number of publications (n° publications) reporting on results achieved using the samples of human biological material during 1 year (2013 blue, 2014 orange, 2015 gray). The figure demonstrates an overall increase in number of publications. The total number of publications was split up highlighting two distinct categories: most of the studies were multicentric with an increasing number of the years. This highlights one of the needs/advantages in relatively rare diseases. The other highlight is the proportional increase of studies whereby the industry was one the scientific partners (participation not limited to sponsoring) which demonstrates one of the strengths of Biobanking.

Figure 2

Time points and sample collection of the PANTHER cohort. Biopsies are only collected when a colonoscopy is required for clinical follow-up. If macroscopic inflammation is present, a biopsy is taken both at an inflamed site, and a macroscopically inactive site. Bright arrow colors indicate required samples; faint colors indicate optional samples. Dx, diagnosis; m, month.

Figure 3

Overview of the Belgian biobanks currently connected to the BBMRI.be network. The BBMRI.be network connects 13 biobanks that are linked to public institutions such as hospitals, universities, and research centers.