The GEM Project Continues to Dazzle

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The Genetic, Environment and Microbiome (GEM) Project is the world’s largest prospective study to investigate the causes of Crohn’s disease, propelled by a $12.5 million commitment from Crohn’s and Colitis Canada.

Since 2008, researchers have monitored the diet, immune function, intestinal barrier, microbiome, genetics, and environmental factors in thousands of healthy but high-risk individuals across seven countries. Our goal: to unearth what factors trigger the disease, as people begin to be diagnosed.

During this current phase, GEM project architect Dr. Ken Croitoru is studying how gut bacteria functions differently before Crohn’s is diagnosed, and which microorganisms protect or expose people to the disease. In an innovative new approach, his team at Toronto’s Mt. Sinai Hospital is culturing bacterial communities from 800 stool samples of GEM participants.

By testing these cultured communities, we in turn have a renewable microbiome resource linked to health and disease, we can also test their functional properties, and understand the conditions that may prevent or promote beneficial or harmful effects.”

- Dr. Ken Croitoru

By culturing, researchers can study the complex ecosystem of microorganisms inside our intestines. It is a window to isolate how specific bacteria functions – and their resulting impact on human health.
Early returns show that the microbiota plays a major role in how Crohn’s develops, and the
team aims to pinpoint the specific gut bacteria responsible – opening new therapeutic targets for patients. Since each person’s microbiota behaves differently, we may be able to develop treatment plans and preventative strategies that are personalized in nature.

This builds on other recent discoveries through GEM, including finding an abnormal gut barrier function, higher levels of antimicrobial antibodies, and a specific bacterial signature in healthy people who later developed Crohn’s. We know now that these are predictive signals of the disease and help us protect those at risk.

“Without the recognition by Crohn’s and Colitis Canada donors and their ongoing commitment to the GEM project, we would not be in the position we are today to explore the mechanisms that lead to Crohn’s disease,” says Dr. Croitoru.

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  • Canada has among the highest incidence rates of Crohn's and colitis in the world.
  • 1 in 140 Canadians lives with Crohn’s or colitis.
  • Families new to Canada are developing these diseases for the first time.
  • Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
  • People are most commonly diagnosed before age 30.

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