IBD Surgery Research

At present, Dr. Fleshner and the IBIRI Surgery Research team are studying the relationship of biologic therapies to surgical outcome. Defining molecular signatures and biomarkers for translational efforts have contributed— and continue to contribute—to identifying biomarkers and molecular signatures for subgroups of patients likely to respond to certain biologics. The group is also collaborating with the basic science component to research linking genetic variants and biomarkers of IBD with surgical outcomes and identifying phenotypically distinct subgroups. Dr. Fleshner and team are playing a key role in research to understand the microbiome. He is collaborating on a research project to investigate the role of creeping fat, which early evidence suggests may have a role in fibrosis, or scarring, a hallmark of severe Crohn's disease. The team is also collaborating on a study investigating the novel use of stem cell derived human intestinal organoids.

Current projects underway include:

• Refinement of a new technique for ileal pouch-anal anastomosis surgery involving novel ways to remove the colon without an incision, and which may also reduce perioperative complications and improve long-term functional outcomes
• Collaboration with Dr. Targan and Dr. Gonsky to study novel molecular signatures for subgroups of patients likely to respond to certain biologics in a project that has recently led to the discovery of potential therapeutic targets
• Collaborative study of creeping fat, with Dr. Suzanne Devkota, which early evidence suggests may have a role in fibrosis, a hallmark of severe Crohn's disease
• Investigation with Dr. Robert Barrett of a novel use of stem cell-derived human intestinal organoids in a surgical technique
• International, multicentered clinical trial of adult allogeneic expanded adipose-derived stem cells, for the treatment of complex perianal fistula(s) in patients with Crohn's disease