19 May

World Inflammatory Bowel Disease Day (ulcerative colitis)

World Inflammatory Bowel Disease Day (ulcerative colitis)

Today is World Inflammatory Bowel Disease (IBD) Day; IBD is a set of chronic disorders of unknown cause affecting the gastrointestinal system in over 50 million people. The most common forms are Crohn’s disease and ulcerative colitis. This year we will be focusing on the latter.

Ulcerative Colitis (UC) affects colon with variable extension from rectum to the whole colon, and causes inflammation of its superficial layers (mucusal layer). The most common symptoms are bloody diarrhoea accompanied by abdominal pain. Other symptoms include: urgency to defecate, incontinence, fatigue and anaemia. The disease may have also extraintestinal manifestation affecting the skin, eyes or joints. In the most severe cases, toxic megacolon occurs, where the colon wall dilates and thins, which can lead to intestinal perforation and peritonitis.

UC appears due to an immunological reaction to components of the microbiota in persons with a genetic predisposition triggered by environmental stimuli. Some studies have observed that tobacco has a protective effect against its development.

Diagnosis is in many cases delayed: it is estimated that up to 45% of patients suffered from symptoms over a year when the diagnosis is established, while 17% wait over five years. Moreover, current treatments are not a cure, they simply alleviate the symptoms and extend periods of remission.

Specialists, such as Dr Julià Panés, head of the Inflammatory Bowel Disease team at Hospital ClínicIDIBAPS, state “we need specific IBD markers for diagnosis in the early stages of both the disease and flare-ups” in order to improve the effectiveness of treatment options.

New Non-Invasive Diagnostic Test

Along these lines, the public-private research being carried out in Catalonia is opening doors. GoodGut, for example, is developing a non-invasive test that is currently in the clinical trial phase with patients at the Hospital Universitari Josep Trueta de Girona. It is called RAID-CD and is based on identifying biomarkers in faeces, which will allow early detection of the disease and flare-ups to be predicted. It is designed to optimize therapies by early interventions and reduce the need of surgical operations.

06 Feb

Dr Castells: “We need to anticipate the appearance of colorectal cancer”

Dr Castells: “We need to anticipate the appearance of colorectal cancer”

Doctor Antoni Castells, specialist in gastroenterology, is medical director of Barcelona’s Hospital Clínic, co-coordinator of the Barcelona’s colorectal cancer detection programme and medical adviser to the biotechnology company GoodGut. In the research field, Castells leads the Gastrointestinal and Pancreatic Oncological Research Group of the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and of the Liver and Digestive Diseases Biomedical Research Centre (CIBERehd). We are interviewing him because GoodGut has just presented the first positive results from the clinical trial conducted of the new non-invasive RAID-CRC test for preventing and diagnosing colon and rectal cancer, which could be on the market in 2019.

What are the most pressing challenges in combating colorectal cancer?

In my opinion we are currently facing three main generic challenges in the research against colon and rectal cancers. The first is to try to make treatments more effective and less toxic, an area in which significant progress has been made in recent years and where the prognosis has improved. The second is to seek less invasive diagnostic methods. Currently the main method is via colonoscopy, an excellent and very effective test, but one which is invasive and requires preparation meaning that, although rare, the procedure may lead to complications. The third is to anticipate the appearance of cancer and implement strategies helping us to prevent it. We need to detect it at an earlier phase, when it is what we call a polyp or adenoma, to prevent the lesion progressing to become cancer.

Are these challenges faced worldwide?

Yes, in most developed countries we are more or less at this same preventive or prevention research stage.

Is the primary state of the polyp not currently diagnosed?

Yes, we have various ways of detecting it in this phase. The most effective is the colonoscopy. As I was saying before, this is a tool that is used a lot because very small lesions, such as polyps, can be detected. Then there are other methods to identify persons with a high probability of having this lesion, to find out whether it is worth carrying out a colonoscopy. Of these methods, which we call markers, the most normal is detecting blood in stools. Finding blood in stools can mean many other things, not necessarily either a polyp or cancer, but we feel that if found it is worth carrying out a colonoscopy on this person. The research by companies such as GoodGut is offering us other markers, at different phases of development and market readiness, which have the same purpose but are not invasive and are more efficient.

What is your assessment of the situation for preventive programmes in Catalonia?

Ten years ago they did not exist, or maybe there were was a pilot study; today the whole population of Catalonia is covered by these programmes which have proven to reduce the mortality rate for colon cancer. As a country we should be pleased we have them. However, for any preventive or therapeutic programme it is also possible to seek even more sensitive and specific strategies that improve mortality and save resources, such as the new test GoodGut is developing.

 

“The initial results demonstrate that the RAID-CRC is a more specific test than the faecal occult test”

You are a member of the advisory board of GoodGut, the biotechnology company which is developing the RAID-CRC test. How will this test contribute to progress in preventing and diagnosing colon and rectal cancer?

This test is extremely innovative because it is the first time markers deriving from the bacteria present in the gut are used to identify persons with cancer or polyps. We do not really know if the changes in flora precede the cancer or if the cancer changes the flora but, whatever the case, what we see is that these microbial markers identify the persons who have these lesions. The current results, which are still very early, demonstrate this correlation. If these results are confirmed with larger studies, especially in populations without symptoms or any type of manifestation leading them to think they may have cancer, which is the population we consider ideal for screening or prevention, the RAID-CRC could be a more specific test than the current faecal occult blood test. This would reduce unnecessary colonoscopies for those who give a positive result in the blood test and do not actually have cancer, with the benefits this provides for both the person and the health system.

Will the RAID-CRC now be validated in a wider population?

Yes, a validation study will begin shortly on 2,500 people in Germany, a country where colorectal cancer is prevented by means of colonoscopy. This will provide us with colonoscopies from persons with cancer or polyps and those who are healthy. This will allow us to validate the usefulness of the RAID-CRC.

If the results of the final study are positive, will Catalonia again be at the forefront of an advance in biomedical research?

In the field of preventing colon cancer, we are in an excellent position. If the results obtained so far are confirmed with this larger cohort of persons with risk of colon cancer, the country’s position will certainly be consolidated around the world.

According to the World Health Organisation, colorectal cancer is the third most common form of cancer in the world.

That is correct, what happens is that the frequency changes significantly according to country. For example, if we take only Western European countries, the United States and Asia, it is not only the third most common, but becomes the second for women and third for men.

Can you make a future prediction about its incidence?

The tendency we have seen in recent years in most countries without colorectal cancer screening is that the incidence has risen. What we are also starting to see is that in countries that have set up preventive programmes the incidence has stabilised and there are signs that in some it is beginning to fall.

Photo: Hospital Clínic

19 May

World Inflammatory Bowel Diseases’ Day (the Crohn’s disease)

World Inflammatory Bowel Diseases’ Day (the Crohn’s disease)

Today is the World Inflammatory Bowel Diseases’ Day, a group of chronic disorders of unknown origin which affects the gastrointestinal tract of more than 2,500,000 people in Europe. In Spain, there are between 150 and 250 cases every 100,000 inhabitants, of all of them the most common are the Crohn’s disease and the ulcerative colitis. In this post we will focus on the first.

The Crohn disease causes the inflammation of a segment of the intestines, it can affect any part of the digestive tract, but the small intestine last section, also known as ileum, is the most frequent area affected. There is a scientific consensus in that it is an autoimmune illness, but its causes are unknown. Scientists have isolated some risk factors: the main of them is a genetic component (a 20% of the patients have a relative with it), the other factors are: contamination, smoking habits and stress.

Chron’s main symptoms are frequent intestinal movement, diarrhoea and abdominal pain. Other indicators are joint pain, eye or mouth swelling and skin injuries. As a result of the affected intestines’ limited nutritional absorption capabilities some of the patients become anaemic, lose weight or experience fatigue. The illness alternates active phases with low-intensity ones which makes its symptomatology varied and unpredictable. However it is usual that the active periods produce fissures, fistulas and ulcers.

Crohn affects both sexes equally and normally develops in the youth (most cases are diagnosed between ages 15 -35). As a result of its genetic component, it is more prevalent in some ethnic groups, for example, in western Europe the incidence rate is the 6.3 cases every 100,000 inhabitants while in eastern Europe is the 3,3, according to the US National Library of Medicine National Institutes of Health.

The current treatments are not designed to cure it, only to diminish the symptoms and prolong the inactive periods. The most common medicines used are the corticosteroides and the aminosalicylates. If they are not effective, the doctors will prescribe immunomodulators and some biologic therapy. There is not an established method and the treatment is adapted to each person. In the most extreme cases, the patients are operated to repair or extract the intestine fragment damaged.

A new non-invasive diagnostic test

GoodGut is developing a new non-invasive diagnostic test to detect Inflammatory Bowel diseases like Crohn that is being tested on patients in a clinical study in the Dr.  Josep Trueta University Hospital in Girona. The new method is called RAID-CD and is based in a patented system which identifies bio-markers in the excrements. This will allow an early detection and also the possibility to predict the start of an active phase, with this information it is going to be possible to improve the therapy. The objective is to get a more specific and effective treatment which will avoid the necessity of a surgical procedure in the long-term. “Raid-CD is going to allow a more efficient control of the illness and this will improve the patient quality life” states doctor Xavier Aldeguer, GoodGut co-founder and Director of the Department of Digestive Diseases in Trueta hospital. Among its potential benefits are a reduction of the number colonoscopies needed and an increase in the treatments efficacy.

GoodGut’s therapeutic prebiotic

GoodGut is currently developing Previpect, a therapeutic prebiotic which fosters a selective growth of the beneficial microorganisms we have in our intestinal flora which helps to compensate the dysbiosis that patient usually have. This can reduce the outbreaks and increases the treatments efficacy. This prebiotic can represent a conceptual change in the Inflammatory Bowel Diseases therapy. As it is a prebiotic, its regulation process is faster so it is going to be soon in the market. GoodGut expects it to be available by 2019.

15 Mar

The New Non-Invasive Test from GoodGut, at the 12th Congress of ECCO

The New Non-Invasive Test from GoodGut, at the 12th Congress of ECCO

With the theme Advancing Knowledge, Improving Care, Barcelona played host to the 12th Congress of ECCO (European Crohn’s and Colitis Organisation) on inflammatory bowel disease (IBD). This congress is an unmissable event for scientists and medical specialists from around the world wishing to explore the latest research and clinical care trends in the field.

GoodGut, which began clinical trials of a non-invasive system for detecting IBD (RAID-CD) at Dr. Josep Trueta University Hospital in Girona, with a population of 100 patients, was one of the companies taking part in the congress. IBD includes both Crohn’s disease and ulcerative colitis.

Specifically, two scientific posters were presented by Joan Amoedo, researcher in a team through the Industrial Doctorates Scheme of the Generalitat of Catalonia. The most relevant result on the first poster, which was one of the most consulted, described the excellent capacity of the phylogroups (PHGI and PHGII) to discriminate between ulcerative colitis and Crohn’s disease patients exclusively affecting the colon.

The most significant result on the second poster was that the PHGI and PHGII have proven to be good active phase indicators, providing for the possibility of a different activity marker for each disease. In this case, as Joan Amoedo explains, “it was detected that an increased number of patients was required to validate the markers as a parameter of activity for both diseases”. As a result, the corresponding clinical trials for the differential diagnosis and monitory of inflammatory bowel disease, and the use of these markers to predict the response to anti-TNF treatments such as post-operative recurrence are currently being conducted at Dr. Josep Trueta University Hospital in Girona, Bellvitge University Hospital and Germans Trias i Pujol University Hospital.

Both diseases are chronic and tend to appear in young people (before the age of 30). An estimated 2.5–3 million people in Europe are affected by IBD. In Spain, Crohn’s disease affects around 137.2 people out of every 1000 and, according to ACCU, ulcerative colitis is more common than Crohn’s disease (58% compared to 42%).

Currently IBD is diagnosed with the support of clinical indices and inflammatory parameters such as calprotectin. However these parameters are not sufficiently accurate and generally do not determine when there will be a flare-up of the disease. As a result, a colonoscopy is always necessary, despite being a highly invasive technique with risk of death. In order to diagnose and monitor these chronic diseases the GoodGut system makes it possible to consider one kilogram of bacteria living inside the body which, when unbalanced, are responsible for causing inflammatory response. The RAID-CD can thus be used for non-invasive identification in faeces of the specific microbiological signature for each disease and the degree of dysbioisis can be measured to monitor the disease correctly and provide effective treatment guidelines.

 

 

28 Feb

GoodGut, selected for the IPEM 2017 investment forum in Cannes

GoodGut, selected for the IPEM 2017 investment forum in Cannes

GoodGut was the only Catalan company selected by the European Commission Executive Agency for SMEs (EASME) to take part in the IPEM 2017 investment forum, from 24 to 26 January in Cannes (France), attended by a total of 120 companies.

It is one of the most important occasions in Europe for private and corporate investors seeking business opportunities to meet innovative companies from a range of economic sectors. The CEO of GoodGut, Dr Mariona Serra, was responsible for presenting the business model to over 150 investors from France, Luxembourg, Germany, Belgium, the United States, Canada and China. “IPEM has given us visibility and access to a network of potential investors in the international arena” she told us.

Serra also commented that GoodGut is a pioneer in designing systems to support diagnosis and treatment for digestive diseases based on intestinal microbiota. Along these lines, investors were interested in the company’s two tests currently in pre-clinical trial phase: RAID-CRC as a new non-invasive system for early detection of colorectal cancer using biomarkers, as it is the second highest cause of death by cancer in the world and the cancer which most affects the Spanish population, and RAID-CD for inflammatory bowel diseases, mainly Crohn’s disease and ulcerative colitis.

Since it was founded in 2014, GoodGut has raised €795,000 from family, friends and fools, angel investors, Caixa Capital Risc and Institut Català de Finances (ICF-IFEM), and one million euros of competitive public financing through the Retos and Neotec programmes.