Aliment Pharmacol Ther. 2024 Nov;60(9):1166-1175. doi: 10.1111/apt.18263.

Sérgio Bronze ^1 2 3, Manasi Agrawal ³, Jean-Frédéric Colombel ³, Joana Torres ^2 4 5, Ryan C Ungaro ³

Author information

¹Gastroenterology and Hepatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal.

²Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal.

³Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

⁴Division of Gastroenterology, Hospital da luz Lisboa, Lisbon, Portugal.

⁵Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal.

Abstract

Background: The possibility of preventing inflammatory bowel disease (IBD) is becoming more plausible due to advances in understanding preclinical disease and successful prevention trials in other immune-mediated diseases, such as type 1 diabetes and rheumatoid arthritis. However, before that possibility becomes reality, several efforts need to occur in parallel and in a coordinated way.

Aim: To propose some critical steps necessary for advancing the field of IBD prediction and prevention.

Methods: We reviewed the current literature to identify the necessary steps toward a preventive strategy for IBD.

Results: The first step should determine the most robust predictive biomarkers and validate them across independent cohorts, creating a multidimensional predictive tool. The second step is to gain a better understanding of the preferences of first-degree relatives and people at risk for IBD, informing the implementation of screening and preventive strategies. Third, these efforts should contribute to the development of high-risk clinics and establish the necessary networks for disease prevention trials.

Conclusions: Advancing the field of IBD prediction and prevention will require a multifaceted approach, integrating biomarker discovery, understanding patient preferences, and establishing infrastructure for a collaborative network to support the practical implementation of IBD prevention strategies.