Researchers will investigate whether changes in the gut microbiome induced by six weeks of preoperative exclusive enteral nutrition (EEN) – a specially prescribed nutritional drink that replaces a patient’s entire diet prior to surgery – can predict postoperative outcomes, including wound infections and reduce risk of disease recurrence in adults with Crohn’s disease.
To achieve this, the team will compare changes in the composition and function of the gut microbiome in patients receiving EEN before surgery with those following their usual diet. The research team will also further investigate whether maintaining EEN-induced microbial changes six weeks and six months after surgery correlates with a lower risk of disease recurrence.
The MI-OCEAN team aims to identify the microbiome mechanisms that influence patients’ surgical outcomes and better understand why some patients recover better than others. The team plans to use artificial intelligence to test whether incorporating personal microbiome signatures into clinical data will improve the prediction of patient outcomes, compared to routine clinical data alone.
Professor Gerasimidis said: “We are delighted to receive this significant grant from the Helmsley Charitable Trust. Deciphering the microbial mechanisms of action of EEN could help develop more tolerable nutritional and pharmacological therapies and provide insights into the underlying pathogenesis of Crohn’s disease. Predicting the risk of postoperative outcomes and subsequent disease relapse means that preventive treatment strategies can be implemented quickly.”
Dr. Shefali Soni, Program Officer at the Helmsley Charitable Trust said: “Helmsley is committed to supporting research that advances our understanding of the interactions between diet and gut microbiota in people with Crohn’s disease. This grant provides a unique opportunity to investigate the role of gut microbiomes in surgical patients with Crohn’s disease receiving an EEN protocol. There is a need for research into cost-effective measures that can reduce complications after surgery, an important management strategy for Crohn’s disease.”
The new MI-OCEAN will form part of the ongoing NIHR-HTA (National Institute for Health and Care Research-Health Technology Assessment Programme) funded OCEAN study, led by the University of Birmingham, which aims to understand whether pre -operative A is clinically meaningful. more effective in reducing postoperative outcomes compared with usual diet in patients undergoing surgery for Crohn’s disease. Although EEN shows promise as a preoperative optimization strategy, randomized control trials are necessary before it can become part of the recommended guidelines for the treatment of Crohn’s disease.