Researchers will explore whether changes in the gut microbiome induced by six weeks of pre-surgery Exclusive Enteral Nutrition (EEN) – a specially prescribed nutritional drinks which substitute a patient’s entire diet leading up to surgery – can predict post-operative outcomes, including wound infections, and reduce the risk of disease recurrence in adults with Crohn’s disease.
To achieve this, the team will compare changes in gut microbiome’s composition and function from patients receiving EEN prior to surgery with those maintaining their usual diets. The study team will also further investigate whether maintaining any EEN-induced microbial changes at 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 to better understand why some patients recover better than others. The team plans to use artificial intelligence to test whether including personal microbiome signatures in clinical data will enhance the prediction of patient outcomes, when compared with routine clinical data alone.
Professor Gerasimidis said: “We are delighted to receive this significant grant from the Helmsley Charitable Trust. Decoding the microbial mechanisms of action of EEN could help develop more tolerable dietary and pharmacological therapies and offer insights in underpinning pathogenesis of Crohn’s disease. Prognosticating risk of post-operative outcomes and subsequent disease relapse means preventive treatment strategies can be implemented promptly.”
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 offers a unique opportunity to explore the role of gut microbiomes in surgical patients with Crohn’s disease receiving an EEN protocol. There is a need to investigate cost-effective measures that may reduce complications following 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 seeks to understand whether pre-operative EEN is clinically more effective to reduce post-operative outcomes compared with usual diet in patients undergoing surgery for Crohn’s disease. Although EEN shows promise as a pre-operative optimisation strategy, randomised control trials are necessary before it can be part of the recommended Crohn’s disease management guidelines.
