From molecules to medicine : expanding the therapeutic streetlight for inflammatory bowel diseases

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Abstract/Contents

Abstract
Inflammatory bowel diseases (IBD) comprise a set of largely heterogeneous chronic intestinal disorders and includes ulcerative colitis (UC) and Crohn's disease (CD). Compounding prevalence of IBD, exacerbated by relatively early disease onset, low mortality, and lack of curative therapies, has led to an increasing economic burden on the healthcare system. There may be subsets of patients with IBD whose molecular underpinnings are not yet addressed in the current paradigm of IBD translational research and drug development. This includes epigenetics, which is understudied and could provide mechanistic links between environmental influences and IBD pathology. It is imperative to continue the investigation of novel modalities that may explain more nuanced manifestations of IBD and develop new therapies with the ultimate goal of improving care for patients with IBD. Here, we aimed to address the critical need for novel drug treatments for patients with IBD in two ways. First, we implemented computational drug repositioning via signature matching using publicly available gene expression datasets to identify FDA-approved drugs that can be repurposed to treat patients with UC. We identified atorvastatin as a lead candidate for reversing inflammatory genes from the disease signature, and we validated our findings using a retrospective cohort study design modeled after a target trial and showed that atorvastatin had a protective effect on colectomy risk in patients with UC. Our findings provide a systematic framework for integrating at a large scale to repurpose existing FDA-approved drugs for a wide range of human diseases beyond UC. Secondly, we report single-cell histone acetylation and methylation shifts in multiple hematopoietic cell types from patients with IBD. Using epigenetic landscape profiling by time-of-flight mass cytometry (EpiTOF), we investigated histone and chromatin modification changes in peripheral blood mononuclear cells (PBMCs) from patients with IBD that may peripherally inform local tissue immune responses under disease conditions. Our findings support a role for histone modifications in IBD pathology that can offer new insights into the epigenomic landscape of IBD and ultimately opens the door to a novel class of therapeutics that may be efficacious for patients with IBD.

Description

Type of resource text
Form electronic resource; remote; computer; online resource
Extent 1 online resource.
Place California
Place [Stanford, California]
Publisher [Stanford University]
Copyright date 2021; ©2021
Publication date 2021; 2021
Issuance monographic
Language English

Creators/Contributors

Author Bai, Lawrence
Degree supervisor Habtezion, Aida
Degree supervisor Khatri, Purvesh
Thesis advisor Habtezion, Aida
Thesis advisor Khatri, Purvesh
Thesis advisor Sage, Julien
Thesis advisor Utz, PJ
Degree committee member Sage, Julien
Degree committee member Utz, PJ
Associated with Stanford University, Program in Immunology

Subjects

Genre Theses
Genre Text

Bibliographic information

Statement of responsibility Lawrence Bai.
Note Submitted to the Program in Immunology.
Thesis Thesis Ph.D. Stanford University 2021.
Location https://purl.stanford.edu/ks452hc6793

Access conditions

Copyright
© 2021 by Lawrence Bai
License
This work is licensed under a Creative Commons Attribution Non Commercial 3.0 Unported license (CC BY-NC).

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