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NCDD Common Themes Note • The “common themes” were developed from a review of the PowerPoint presentations and the Research Goals spreadsheet. They are presented in a highly truncated bullet form and are not in any particular order. • In searching for commonalities amongst the goals presented by the 12 Working Groups, specifics such as cells, pathways, molecules, and diseases were eliminated—not because they lacked significance within individual WGs—but in order to capture ideas that applied to the entire field of DD research. A few items that did not appear in the presentations have been added. • The themes suggest overarching ideas and are offered as a tool—along with the Research Goals and the Challenges and Steps to Achieve Goals spreadsheets—to assist you in reviewing the WG presentations in order to decide on what goals to recommend for the long-range plan for digestive diseases research. They may also suggest overarching challenges and steps and identify additional items within the NCDD Charter’s requirements such as the need for training/education and communication strategies. Animal models • • • • • Development Model organisms—novel genes, pathways Disease Pathogenesis Pre clinical testing Needed resource to overcome barriers Genetics • • • • • • Genetic basis of complex diseases Pathways in pathogenesis Clues to environmental factors Diagnostic markers Pharmacogenomics Epigenetics—cancer pathogenesis Microbiology • Define microbiome of human gut and model organisms – – – – – Metagenomics Metabolomics Host-microbiome-nutrient interactions Modifiers of development, disease Prebiotics, Probiotics • Rapid diagnostics • Prevention: vaccines • Therapeutics: novel Rx, multi-drug Rx Biomarkers • Refine clinical phenotypes with biomarkers, surrogate markers • Diagnosis, stage, predict natural history, predict and assess response to therapy • Surrogate markers for clinical trials Regeneration • • • • • Stem cell biology Repair factors Gene, cell therapies, support devices Innovative surgical approaches Nutrition, micronutrients, pre/pro biotics Molecular and cell biology • Comprehensive analysis of cell biology of different cell types • Cell-cell communication • Tissue and whole organism biology • “Omics” databases, informatics tools, linkage of different disciplines • Alternations in disease states • Targeted therapeutics, diagnostics Epidemiology • Descriptive epidemiology of digestive diseases • Natural history • Identification of risk factors • Response to therapy • Resource utilization • Needed resources: registries, common nomenclature Digestive Disease Symptoms • • • • • • • Defined nomenclature Tools for assessment Physiological basis Brain gut interactions Modifiers Novel therapies QOL Imaging • Improved imaging: physical, probes, functional • Imaging based novel therapies Innovative technologies: Diagnosis, Treatment, and Research • • • • • • Endoscopic Surgical Non-invasive: capsule Electrical: stimulation, pacing Robotics Tissue ablation Patient Phenotyping • • • • • Standardized nomenclature Standardized diagnostic criteria Biomarkers Novel physiological tests Genotyping Common Research Needs • Resources: Animals, tissues, libraries, databases, informatics tools, disease networks • Human: Career pathways, interdisciplinary teams, clinical research training, financial models • Lower barriers: HIPAA, IRB, electronic medical record integration with research data, public-private partnerships Education • Increase public and professional awareness of medical advances • Prevention • Implementation of treatment advances Immunology and Inflammation • Protective/harmful mechanisms – Adaptive immunity – Innate immunity – Inflammation • Contribution of immune mechanisms to interactions with other cell types, GI physiology, repair • Novel therapies: biologics, cells, tolerance • Prevention: vaccines Clinical trials • Innovative clinical trials in digestive diseases: drugs, biologics, devices, behavioral Rx, combinations • Clinical research infrastructure: patients, clinical investigators, regulatory, industry partnerships, repositories • Needs of special populations: women, minorities, children, health disparities • Post-marketing: Effectiveness, safety, practice guidelines