Natural history, immunological and genetic characteristics of preclinical inflammatory bowel disease (EARLY): study protocol for a prospective cohort study

Background: The period prior to the diagnosis of inflammatory bowel disease (IBD), defined as the preclinical phase, has emerged as a potential target for disease modification strategies. Despite the relevance of an early diagnosis to the prognosis of the disease, only a limited number of patients a...

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Main Authors: Iago Rodríguez-Lago, Urko M. Marigorta, Beatriz Mateos, Míriam Mañosa, Lucía Márquez-Mosquera, Luis Menchén, Francisco Rodríguez-Moranta, Inmaculada Alonso, Mariam Aguas, Horacio Alonso-Galán, Pere Borràs, Beatriz Castro, Eugeni Domènech, Rocío Ferreiro-Iglesias, Ruth de Francisco, Francisco Javier García-Alonso, Natalia García, Orlando García-Bosch, Carla Gargallo, Javier P. Gisbert, Eva Iglesias, Francisco Mesonero, Jone Ortiz de Zárate, Laura Ramos, Empar Sáinz, Pablo Ladrón, Carles Suria, Cristina Suárez Ferrer, Coral Tejido, Pilar Varela, Raquel Vicente, Yamile Zabana, Gisela Castany, Eva Rodríguez, Ana Gutiérrez, Manuel Barreiro-de Acosta
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Therapeutic Advances in Gastroenterology
Online Access:https://doi.org/10.1177/17562848251338647
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author Iago Rodríguez-Lago
Urko M. Marigorta
Beatriz Mateos
Míriam Mañosa
Lucía Márquez-Mosquera
Luis Menchén
Francisco Rodríguez-Moranta
Inmaculada Alonso
Mariam Aguas
Horacio Alonso-Galán
Pere Borràs
Beatriz Castro
Eugeni Domènech
Rocío Ferreiro-Iglesias
Ruth de Francisco
Francisco Javier García-Alonso
Natalia García
Orlando García-Bosch
Carla Gargallo
Javier P. Gisbert
Eva Iglesias
Francisco Mesonero
Jone Ortiz de Zárate
Laura Ramos
Empar Sáinz
Pablo Ladrón
Carles Suria
Cristina Suárez Ferrer
Coral Tejido
Pilar Varela
Raquel Vicente
Yamile Zabana
Gisela Castany
Eva Rodríguez
Ana Gutiérrez
Manuel Barreiro-de Acosta
author_facet Iago Rodríguez-Lago
Urko M. Marigorta
Beatriz Mateos
Míriam Mañosa
Lucía Márquez-Mosquera
Luis Menchén
Francisco Rodríguez-Moranta
Inmaculada Alonso
Mariam Aguas
Horacio Alonso-Galán
Pere Borràs
Beatriz Castro
Eugeni Domènech
Rocío Ferreiro-Iglesias
Ruth de Francisco
Francisco Javier García-Alonso
Natalia García
Orlando García-Bosch
Carla Gargallo
Javier P. Gisbert
Eva Iglesias
Francisco Mesonero
Jone Ortiz de Zárate
Laura Ramos
Empar Sáinz
Pablo Ladrón
Carles Suria
Cristina Suárez Ferrer
Coral Tejido
Pilar Varela
Raquel Vicente
Yamile Zabana
Gisela Castany
Eva Rodríguez
Ana Gutiérrez
Manuel Barreiro-de Acosta
author_sort Iago Rodríguez-Lago
collection DOAJ
description Background: The period prior to the diagnosis of inflammatory bowel disease (IBD), defined as the preclinical phase, has emerged as a potential target for disease modification strategies. Despite the relevance of an early diagnosis to the prognosis of the disease, only a limited number of patients are diagnosed during this window of opportunity. Objectives: To determine the risk of developing symptoms after an incidental diagnosis of IBD and to describe the clinical, genetic, and immunological characteristics of IBD during its preclinical phase. Design: This study protocol describes a prospective, multicenter cohort study in which incidental (i.e., asymptomatic) IBD within the colorectal cancer screening program will be characterized from a clinical and multi-omic perspective and compared with symptomatic patients and healthy non-IBD controls. Methods: Samples from blood, urine, stool, and intestinal endoscopic biopsies will be obtained at baseline. A second sample set will be obtained after 52 weeks from those who remain asymptomatic; samples will also be obtained in those with new-onset symptoms. Medical treatment will be prescribed in all patients following current guidelines. Follow-up visits will be performed every 6 months for 10 years, and all new-onset symptoms, changes in disease behavior, extraintestinal manifestations, IBD-related medical therapies, or surgeries will be recorded. Two control cohorts will be included: one including recently diagnosed symptomatic IBD patients (<3 months), and another with healthy non-IBD controls after a normal ileocolonoscopy, in whom samples will be obtained at baseline. Samples from patients and controls will undergo genetic, proteomic, transcriptomic, single-cell RNA sequencing, metabolomic, and microbiome analyses, and integration of data between the different omic perspectives will also be performed. The study has been approved by the Basque Country Ethics Committee (PI2021116). Conclusion: EARLY will generate a unique dataset addressing a previously unexplored area of IBD, with the final aim of describing the prognosis of patients from its earlier phases on the disease and integrating clinical and omic data into useful tools for the long-term prediction of disease outcomes. Trial registration: NCT05698745.
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spelling doaj-art-0e3c6a39bf454d7c98d0e1c756d710422025-08-20T02:58:41ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-05-011810.1177/17562848251338647Natural history, immunological and genetic characteristics of preclinical inflammatory bowel disease (EARLY): study protocol for a prospective cohort studyIago Rodríguez-LagoUrko M. MarigortaBeatriz MateosMíriam MañosaLucía Márquez-MosqueraLuis MenchénFrancisco Rodríguez-MorantaInmaculada AlonsoMariam AguasHoracio Alonso-GalánPere BorràsBeatriz CastroEugeni DomènechRocío Ferreiro-IglesiasRuth de FranciscoFrancisco Javier García-AlonsoNatalia GarcíaOrlando García-BoschCarla GargalloJavier P. GisbertEva IglesiasFrancisco MesoneroJone Ortiz de ZárateLaura RamosEmpar SáinzPablo LadrónCarles SuriaCristina Suárez FerrerCoral TejidoPilar VarelaRaquel VicenteYamile ZabanaGisela CastanyEva RodríguezAna GutiérrezManuel Barreiro-de AcostaBackground: The period prior to the diagnosis of inflammatory bowel disease (IBD), defined as the preclinical phase, has emerged as a potential target for disease modification strategies. Despite the relevance of an early diagnosis to the prognosis of the disease, only a limited number of patients are diagnosed during this window of opportunity. Objectives: To determine the risk of developing symptoms after an incidental diagnosis of IBD and to describe the clinical, genetic, and immunological characteristics of IBD during its preclinical phase. Design: This study protocol describes a prospective, multicenter cohort study in which incidental (i.e., asymptomatic) IBD within the colorectal cancer screening program will be characterized from a clinical and multi-omic perspective and compared with symptomatic patients and healthy non-IBD controls. Methods: Samples from blood, urine, stool, and intestinal endoscopic biopsies will be obtained at baseline. A second sample set will be obtained after 52 weeks from those who remain asymptomatic; samples will also be obtained in those with new-onset symptoms. Medical treatment will be prescribed in all patients following current guidelines. Follow-up visits will be performed every 6 months for 10 years, and all new-onset symptoms, changes in disease behavior, extraintestinal manifestations, IBD-related medical therapies, or surgeries will be recorded. Two control cohorts will be included: one including recently diagnosed symptomatic IBD patients (<3 months), and another with healthy non-IBD controls after a normal ileocolonoscopy, in whom samples will be obtained at baseline. Samples from patients and controls will undergo genetic, proteomic, transcriptomic, single-cell RNA sequencing, metabolomic, and microbiome analyses, and integration of data between the different omic perspectives will also be performed. The study has been approved by the Basque Country Ethics Committee (PI2021116). Conclusion: EARLY will generate a unique dataset addressing a previously unexplored area of IBD, with the final aim of describing the prognosis of patients from its earlier phases on the disease and integrating clinical and omic data into useful tools for the long-term prediction of disease outcomes. Trial registration: NCT05698745.https://doi.org/10.1177/17562848251338647
spellingShingle Iago Rodríguez-Lago
Urko M. Marigorta
Beatriz Mateos
Míriam Mañosa
Lucía Márquez-Mosquera
Luis Menchén
Francisco Rodríguez-Moranta
Inmaculada Alonso
Mariam Aguas
Horacio Alonso-Galán
Pere Borràs
Beatriz Castro
Eugeni Domènech
Rocío Ferreiro-Iglesias
Ruth de Francisco
Francisco Javier García-Alonso
Natalia García
Orlando García-Bosch
Carla Gargallo
Javier P. Gisbert
Eva Iglesias
Francisco Mesonero
Jone Ortiz de Zárate
Laura Ramos
Empar Sáinz
Pablo Ladrón
Carles Suria
Cristina Suárez Ferrer
Coral Tejido
Pilar Varela
Raquel Vicente
Yamile Zabana
Gisela Castany
Eva Rodríguez
Ana Gutiérrez
Manuel Barreiro-de Acosta
Natural history, immunological and genetic characteristics of preclinical inflammatory bowel disease (EARLY): study protocol for a prospective cohort study
Therapeutic Advances in Gastroenterology
title Natural history, immunological and genetic characteristics of preclinical inflammatory bowel disease (EARLY): study protocol for a prospective cohort study
title_full Natural history, immunological and genetic characteristics of preclinical inflammatory bowel disease (EARLY): study protocol for a prospective cohort study
title_fullStr Natural history, immunological and genetic characteristics of preclinical inflammatory bowel disease (EARLY): study protocol for a prospective cohort study
title_full_unstemmed Natural history, immunological and genetic characteristics of preclinical inflammatory bowel disease (EARLY): study protocol for a prospective cohort study
title_short Natural history, immunological and genetic characteristics of preclinical inflammatory bowel disease (EARLY): study protocol for a prospective cohort study
title_sort natural history immunological and genetic characteristics of preclinical inflammatory bowel disease early study protocol for a prospective cohort study
url https://doi.org/10.1177/17562848251338647
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