The GEM Project


The Crohn’s and Colitis Canada Genetic, Environmental, Microbial (GEM) Project is a global research study that looks to uncover possible triggers of Crohn’s disease. The more we know about the possible causes of Crohn’s, the closer we get not only to a cure, but also to the ability to prevent the disease from taking hold in the first place.
Initiated in 2008, the GEM Project sought to recruit first-degree relatives (FDRs) of Crohn’s patients. Recruited participants did not have Crohn’s, but would be monitored to see if they would develop the disease. Researchers tracked their diet, immune function, intestinal barrier, microbiome, genetics, and environment. By examining these factors, researchers hoped to pinpoint the triggers of Crohn’s in the participants who ended up being diagnosed with the inflammatory bowel disease. 
“If we can understand why in family members it is occurring… and if it’s in a modifiable factor…could we decrease somebody’s risk of ultimately going on to develop Crohn’s disease?”
Dr. Tony Otley
Head of Gastroenterology & Nutrition, IWK Health Centre, Halifax
Where the project stands
As of July 2020, the GEM Project has:
  • 107 global recruitment sites, with locations in Canada, Israel, the United States, Sweden, the United Kingdom, New Zealand, and Australia
  • Recruited 5085 FDRs
  • 95 participants have been diagnosed with Crohn’s disease

Map indicating recruitment sites for Gem participants. 15 in USA, 25 in Canada, 38 in the UK, 3 in Sweden, 18 in Israel, 1 in Australia, and 7 in New Zealand.

What GEM can tell us, and where it can lead us
Researchers have discovered certain biomarkers - changes in blood and tissue - have begun to appear more frequently than others in the participants who developed Crohn’s disease. Further exploration of these biomarkers will make it possible for researchers to develop predictive tests that can identify individuals who will develop the disease, even before symptoms appear.
Testing, in turn, leads to earlier medical interventions, more accurate and personalized treatment, lower health care costs, and most importantly, a better quality of life for people with Crohn’s disease.
While Crohn’s disease is known to have a genetic link, the genetic elements that cause Crohn’s to develop in some people but not others needs to be better understood. With our recruitment goal met and a statistically meaningful patient population now exhibiting Crohn’s disease, we can work to uncover the parameters that lead to the onset of disease.

Dr. Ken Croitoru

GEM Project Architect and Lead Investigator, Mount Sinai Hospital, Toronto
The greatest ambition of the GEM Project is to gain a greater knowledge of the triggers of Crohn’s disease, so that researchers can uncover ways to prevent the disease from developing in the first place.
While the GEM Project focuses on Crohn’s disease, the research amassed also feeds in to our understanding of ulcerative colitis, which could lead to more targeted, and more effective, treatments.
“When you suffer from Crohn’s, your whole family suffers. I’ve had three surgeries and countless trips to the emergency room, which has been incredibly hard on our entire family, but particularly my sons. The GEM Project is not only important research, but it’s a way for family members to feel like they are contributing to helping researchers better understand the disease and maybe to one day find a cure.”
Sherry, mother of two sons who are participants in the GEM Project

Learn about the progress of the GEM Project at our recent Gutsy Learning Series event


GEM study links leaky gut to Crohn's disease
Study seeking cause of Crohn’s disease hopes to develop predictive test
Study into the causes of Crohn’s disease hits major milestone
International research team seeking Crohn’s disease causes by studying family factors
Fall River family hopes study helps prevent children from getting debilitating disease

This unprecedented research is led by Crohn’s and Colitis Canada and steered by Dr. Ken Croitoru at Mount Sinai Hospital in Toronto. Funding for the GEM Project has been provided by Crohn’s and Colitis Canada and The Leona M. and Harry B. Helmsley Charitable Trust.

  • 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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