Ongoing Research Projects

To study the relationship between medications, the gut microbiome, and risk of microscopic colitis in older adults, we will investigate three major goals. First, we will identify pharmacologic determinants of MC, leveraging a nationwide cohort of all MC patients (n~14,000) in Sweden to identify medications associated with risk of the disease. Second, we will characterize compositional and temporal changes in the gut microbiota related to disease activity in MC (n = 200) and identify microbial signatures of MC among older adults with chronic diarrhea (n = 400) in our prospective colonoscopy-based cohort using metagenomic sequencing. Third, we will identify the microbial and metabolite mediators of the association between medications and risk of MC.

Through the NIH Common Fund’s Nutrition for Precision Health Clinical Center program, we will collaborate with New England-based research teams to conduct multiple dietary intervention studies for the purpose of developing precision health for nutrition. Specifically, we will enroll a cohort of individuals heterogenous in demographics, clinical characteristics, health parameters, and disease risk factors and apply Artificial Intelligence (AI) methods to understand and predict an individual’s response to foods, nutrients, food components, and dietary patterns.

We received funding from the American College of Gastroenterology to characterize the transcriptome of epithelial and immune cell populations in patients with microscopic colitis and compare that to healthy controls. Additionally, we will identify genes and biological pathways that are enriched in emerging epithelial and immune cell populations during the active phase of microscopic colitis compared to healthy controls. This work will ultimately lead to the establishment of a comprehensive single-cell compendium of normal colonic mucosa and microscopic colitis, which will provide significant insight into the complex and heterogenous structure of the human gut mucosa and serve as a platform to facilitate future work in other inflammatory bowel disorders.

We are conducting a randomized controlled trial to examine the influence of Mediterranean diet and Specific Carbohydrate Diet (SCD) on gut microbiota, luminal inflammation, and disease-specific clinical indices in patients with mild to moderate ulcerative colitis (UC). This comprehensive examination of the complex interaction between diet, gut commensal bacteria, and luminal inflammation will provide an unprecedented opportunity to assess the utility of dietary recommendations in the UC treatment paradigm. https://clinicaltrials.gov/ct2/show/NCT04398550 

With support from the Crohn’s and Colitis Foundation, we will: 1) examine the association between diet, lifestyle and medications and incident elderly-onset IBD; 2) identify plasma metabolomic profiles that are associated with risk of elderly-onset IBD; and 3) determine whether the relationship between dietary and lifestyle factors and risk of elderly-onset IBD is mediated by plasma metabolites. This research is important to further our understanding of why elderly patients develop IBD and help us design interventions to prevent IBD in this population.

Through funding from Pfizer, we are examining  1) the impact of anti-TNF therapy on body weight, body mass index, and lipid profile; and 2) the relationship between statin use and risk of IBD progression as defined by rates of steroids prescription, use of biologic therapy, and colectomy. We will leverage a cohort of IBD patients at MGH with detailed data on demographics, lifestyle factors, medications, disease activity indices and inflammatory markers, as well as the Swedish Patient Registry which includes over 39,000 incident IBD cases.