Professor David Wilson

2015 - BSPGHAN/Core Development Award

Title: Health informatics research in paediatric gastroenterology: nationwide data-linkage exploration of perinatal risk factors for and consequences of paediatric-onset Inflammatory Bowel Disease

Project Start Date: 1 November 2015

Completion Date: 30 April 2017

Inflammatory bowel disease (IBD) is a complex immune disease which commonly presents in childhood/adolescence, with marked effects on growth, development, and education. Paediatric-onset IBD (PIBD: onset less than 16 years of age) occurs more frequently in Scotland than in the rest of the UK, and its incidence is continuing to rise. Although there have been remarkable recent successes in identifying genetic factors that increase the likelihood of developing IBD, genetic factors alone cannot be the cause of the sustained rise in new cases per head of population in Scotland over a relatively short period (the past 40 years). Instead, trigger factors in our environment interact with people’s genetic make-up in a process called epigenetics. This allows our inherited genetic codes to be switched on or off, and can occur particularly in the womb and at the time of birth, then at puberty. Epigenetics has been shown to be a process through which environmental triggers can modify the activity of our genes. Recent scientific studies suggest that susceptibility to immune diseases (such as IBD) may be determined in the perinatal period, the time around birth. Other evidence suggests that immune disease in early life is associated with inflammatory diseases (affecting the heart and major body and brain blood vessels) and cancer in later life, and may be associated with a risk of earlier death compared with non-affected people. Use of powerful data-linkage methods for the whole population of Scotland will allow us to explore not only the perinatal influences on development of PIBD, but also the later consequences of chronic childhood disease (morbidity and mortality) in early adulthood.