The Jess Group: Molecular prediction of inflammatory bowel disease

Professor Tine Jess is the Director of the PREDICT Center and is chairing the activities of the center.

She has a specific interest in the molecular prediction of inflammatory bowel disease (IBD), both in terms of development and course of disease.

The key resource is The Danish National Biobank, which stores neonatal blood spots and blood samples drawn before and after IBD diagnosis. These samples are linkable to the Danish nationwide registers which record longitudinal data on disease diagnoses, medications, and endoscopic and surgical procedures for all patients with IBD in Denmark. The samples in the Danish National Biobank and the nationwide registers are furthermore linkable to the Danish National Birth Cohort, a nationwide study of pregnant women and their offspring, including granular data on lifestyle and environmental risk factors on more than 100,000 women and their offspring.

Utilizing neonatal blood spots and blood samples from the Danish National Biobank for patients with IBD sampled up to 20 years before IBD diagnosis, the group uses multi-omics technologies to identify the triggering events and early pathogenic pathways of IBD. In addition to elucidating the etiopathogenesis of IBD, this research is also expected to pave the way for a new omics-based classification of IBD beyond clinical and organ-based phenotyping. The sample sizes for the investigations are substantial as the biobank holds neonatal blood spots on more than 10,000 individuals who later developed IBD, blood samples drawn before diagnosis of IBD on more than 3000 individuals, and post-diagnostic samples on more than 15,000 individuals.

In addition to exploring the molecular patterns behind development and course of IBD, the Jess group has a specific interest in phenome-wide association studies, co-morbidities to IBD, and risk of cancer in IBD.

Tine Jess is Professor MD DMSc, Director of the National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease, PREDICT. She is Fellow of the Royal Danish Academy for Sciences and Letters and Member of the Danish Council for Research and Innovation advising the Danish Parliament. Professor Jess is highly cited in the field of IBD and recipient of several awards and honors for her research.
Author ORCID: 0000-0002-4391-7332.

The Allin Group: Clinical epidemiology of inflammatory bowel disease - impact of medications and surgery

The Allin Group explores the clinical epidemiology of inflammatory bowel disease (IBD). The basis of our research is the unique Danish nationwide registers which record unselected longitudinal data for all patients with IBD in Denmark.

At the core of the group’s work is extensive methodological development to best leverage Danish nationwide register-based data. We are immersed in optimizing register-based definitions of IBD and co-morbidities, disease location and phenotypes, and pharmacological and surgical treatments. Efficient use of the nationwide data and state-of-the-art clinical epidemiological study designs, enables clinically impactful studies of long-term outcomes of pharmacological and surgical therapy before and after IBD onset.

Key registers that we use in our research, and which are all linkable via the unique personal identification number assigned to all Danish residents, are:

The Danish Civil Registration System which records demographic and vital data of all residents of Denmark.

The Danish Nationwide Patient Register which contains data on disease diagnoses and endoscopic and surgical procedures for all in- and outpatients in Denmark.

The Danish National Prescription Register which contains data on all prescribed drugs redeemed at Danish pharmacies.

The Danish Pathology Register which holds pathology data on all specimens examined at departments of pathology in Denmark.

The Register of Laboratory Results for Research which holds information on test results of biochemical and immunology analyses performed at departments of biochemistry and immunology in Denmark.

We are also very interested in the impact of environmental health on IBD. Microplastics and other synthetic particles have emerged as pollutants of health concern, and we are funded by the Novo Nordisk Foundation to elucidate the role of microplastics and other synthetic particles in the characteristic and yet unexplained segmental intestinal inflammation of Crohn’s disease. This is an interdisciplinary project involving a close collaboration with Professor Jes Vollertsen, Department of the Built Environment, Aalborg University.

Finally, we have a particular interest in cardiometabolic comorbidity of IBD. We are characterizing the burden of cardiometabolic diseases in patients with IBD, and we explore the pathophysiological mechanisms driving cardiovascular diseases in patients with IBD. We also investigate the mutual effects of the medical and surgical management of IBD and cardiometabolic diseases.

Kristine Højgaard Allin is a medical doctor with a PhD in clinical and genetic epidemiology and a postdoc in microbiome research. Before joining PREDICT as Partner, she was Head of Section for Clinical Epidemiology at the Center for Clinical Research and Prevention in the Capital Region of Denmark.
Kristine Allin is Board member of The Epidemiological Committee (EpiCom) of the European Crohn’s and Colitis Organization, ECCO and The Danish Society for Pharmacoepidemiology. She is also Head of Education in PREDICT.
Author ORCID: 0000-0002-6880-5759.

The Larsen Group: The NorDIBD Cohort

Clinical care of patients with inflammatory bowel diseases (IBD) has been the center of Lone Larsen's clinical work and research. As a Medical Specialist in Gastroenterology, Dr. Larsen works as Chief Physician at Aalborg University Hospital, where she is part of an IBD team caring for around 3,000 IBD patients. With the establishment of the clinical database, GASTROBIO, during her PhD, with granular information on all IBD patients in the North Denmark Region, Dr. Larsen has improved patient care and at the same time, in close collaboration with Dr. Jess, collected data on more than 6,000 patients diagnosed with IBD from 1978 and onwards in this geographical, well-defined area. This cohort is the NorDIBD cohort - the North Denmark IBD cohort - possibly the largest of its kind worldwide.

As partner at PREDICT, Lone Larsen is heading a large study collecting biological samples from all living IBD patients in the North Denmark Region, employing 20 medical students, 2 research nurses, 1 research secretary, and 2 PhD students. Dr. Larsen is also an Associate Professor at Aalborg University and teaches medical students as part of her clinical work.
Author ORCID: 0000-0003-4067-2381.

The Elmahdi Group: Infection, Immunity, and Inflammatory Bowel Disease

The Elmahdi Group is exploring the role of infection in the development of IBD, as well as the long-term impact of infection and infectious outcomes for IBD patients. As part of the group’s work, we are investigating the role of COVID infection and vaccination in IBD patients using the Danish national patient registries. We are also exploring the role of high prevalence, chronic viral infections, including herpesviruses such as EBV and CMV, in the alteration of systemic and gut immunity. A major focus of the group is the use of cutting-edge phage immunoprecipitation sequencing techniques to screen IBD patient serum samples for previous viral exposure. This work is undertaken in collaboration with partners at Statens Serum Institut (SSI), leveraging Denmark’s unique repository of biological patient samples, stored in the Danish National Biobank.

Rahma Elmahdi is an MD who holds a PhD in HIV epidemiology from Imperial College London. Since moving to Denmark in 2019, she has worked with Professor Tine Jess, first in the gastrointestinal disease epidemiology group at SSI then as part of the PREDICT epidemiology team. Dr Elmahdi’s work has focused on the impact of chronic viral infection in IBD, undertaking several population-based studies, and high-quality meta-analysis to explore the potential role of chronic infections such as HIV in altering gut immunity as well as investigating how immunosuppressive therapies, commonly prescribed in IBD, impact chronic infection outcomes, such as HPV, including the risk of benign condyloma as well as malignancies such as cervical cancer in these patients.
Author ORCID: 0000-0002-7013-9548.

The Brusco De Freitas Group: Nutrition and inflammatory bowel disease

Diet appears as a strong candidate among the possible factors involved in the pathogenesis and pathophysiology of Inflammatory Bowel Disease (IBD), considering that some foods are associated with the maintenance of a healthy intestine and, in some way, participate in the regulation of intestinal inflammation through modulation of the microbiota. Various diets have been linked to non-communicable diseases such as obesity, cardiovascular disease, diabetes, and metabolic syndrome. In addition, some evidence shows that maternal nutrition can directly impact fetal development and the quality of the child's diet and susceptibility to disease, requiring greater understanding of the relationship between nutrition and the health-disease process.

The Brusco De Freitas Group, with the participation of important collaborators from PREDICT, the National Center of Excellence and other international institutions, has as its main objective to understand how diet influences the development and worsening of IBD, to improve the quality of life and to pave the way for a better dietary guidance for a growing global number of people with chronic illnesses.

Assistant Professor, Dr. Maiara Brusco De Freitas, PhD, leads this group in collaboration with Professor Tine Jess, MD, DMSc, who is founder and director of PREDICT, and experts in nutrition, epidemiology, gastroenterology and statistics. Dr. Freitas has a degree and a postgraduate degree in nutrition and has relocated to Denmark to build up her own group at PREDICT National Center of Excellence. She has experience in clinical nutrition and population studies related to nutritional status, working mainly in the areas of research related to inflammation, oxidative stress, bariatric surgery, cystic fibrosis, intestinal microbiota, anthropometry, and micronutrient deficiency, and consequently has several publications in scientific journals in specialized areas.
Author ORCID: 0000-0003-1737-8918.

The Julsgaard Group: Pregnancy and inflammatory bowel disease

The Julsgaard group explores aspects related to reproduction and inflammatory bowel disease. The research provide answers to fundamental questions regarding the safety of medical treatment in the preconception period, in pregnancy and during lactation. Further, the risk of surgical procedure in relation to fertility and pregnancy outcome is explored, and health and development in infants of parents with IBD are elucidated. The overall focus is to improve clinical care and evidence-based counselling for women and men with IBD and thereby improve fetal/infant outcome. 

The foundation of the research is data from the unique Danish nationwide registers in combination with analysis on neonatal blood spots in collaboration with partners at Statens Serum Institut (SSI). Moreover, international and national clinical multicenter studies are conducted in order to elucidate all aspects of reproductive health in IBD.

Mette Julsgaard is a gastroenterologist with expertise in inflammatory bowel disease and reproductive health at Aarhus University Hospital, Denmark and Research Associate at PREDICT. Dr. Julsgaard has a PhD in inflammatory bowel disease and pregnancy and a postdoc in biological therapy and pregnancy. In 2012 she completed an honorary gastroenterology research fellowship at St.Vincent’s Hospital, Melbourne university in Australia. Dr. Julsgaard has been the coordinator or invited member of international and national guidelines regarding IBD and pregnancy (European Crohn’s and Colitis Organization, Global Consensus, Danish Society of Gastroenterology & Hepatology, and Danish Society of Obstetrics & Gynecology). Dr. Julsgaard is a board member of the European Crohn’s and Colitis Organization CONFER committee and recipient of several awards and honors for her research in inflammatory bowel disease and pregnancy.
Author ORCID: orcid.org/0000-0003-3070-8950

The Data Science Team

The PREDICT data science team is a multidisciplinary team consisting of both young and experienced biostatisticians, bioinformaticians and data scientists. Our role in PREDICT is to tackle the practical aspects of building the data infrastructure, prepare data sets for analysis, design and perform statistical analyses, as well to assist researchers working on the data themselves.

The team has experience in a wide range of applied statistics covering classical epidemiology, pharmacoepidemiology, human biology and machine learning. The team is also experienced with different data sources ranging from registry, questionnaire, and omics data.

Our data infrastructure is hosted on the Danish National Genome Center’s supercomputer and includes different types of individual-level data from several sources. We focus on developing processes for pseudonymization, documentation, management of permissions and quality control to ensure reproducible research.