Dr John Penders: ‘We hope that this research will enable us to predict or discover IBD earlier.’

Can you tell us something about yourself and your work?

‘My name is John Penders and I am 45 years old. I live near Maastricht and work at the Maastricht University Medical Centre (MUMC) in the Medical Microbiology department. Together with my colleagues, I research our body's microbiome. That means all the micro-organisms that live on and in our bodies and that are so important for our health. I did my training in Maastricht and then also worked in Berlin and California. I was recently appointed professor."

What do you find interesting about your work?

‘I am mainly involved in epidemiology, which is research into the occurrence of disease in large groups of people. But I also feel very much at home in the laboratory. I particularly enjoy the combination of large epidemiological studies and studying the microscopic bacteria in and on our bodies. The microbiome is fascinating because it has so much effect on our health. We are still discovering new species and functions in the microbiome, there is always something new to discover.’

You are conducting research into Irritable Bowel Syndrome (IBD). Can you explain exactly what this research entails?

‘The research project is called ‘Inside Out’. We want to investigate how intestinal bacteria can help to detect Irritable Bowel Syndrome at an early stage. A few years ago, we asked 2000 travellers at traveller vaccination clinics in Amsterdam, Rotterdam and South Limburg to hand in a stool sample and fill in a questionnaire. These were all people who travelled to countries outside of Europe. We already knew that some of the people who contract an intestinal infection while abroad eventually develop IBD. Upon their return to the Netherlands, we again asked these travellers to submit a stool sample and fill out a questionnaire, and then did so a few more times. This allowed us to investigate which of these travellers had had an intestinal infection and which of them subsequently developed IBD symptoms. We are cataloguing all the bacteria present. If we find bacteria that are related to IBD, we will remove them and continue working with them. For example, we will examine how these bacteria affect intestinal motility or whether they cause diarrhoea. This will help us explain possible IBD symptoms.

So we are looking at the entire microbiome of people who developed IBD after an intestinal infection and those who did not. This will allow us to answer the question: why does one person develop IBD after an intestinal infection and the other does not? We will discover who is more susceptible to IBD, and who is less susceptible, and what role the microbiome plays.’

What do you hope to discover in the end?

‘The aim of the research is to gain insight into the development of IBD. We hope to find a microbiome profile that can predict or detect IBD at an early stage. That would be a biomarker for IBD. Finding such a biomarker could help us diagnose IBD earlier and more effectively. But it could also help us find lifestyle adjustments for IBD. So it would not only help with diagnosis, but also with treatment.

In the past, someone would only be diagnosed with IBD after other diseases, such as Crohn's disease, had been ruled out. Nowadays, doctors diagnose IBD based on the symptoms. In principle, this works fine, but the search for a diagnosis and especially a suitable treatment can still be long, tiring and sometimes even unsatisfactory. An objective marker would be very helpful in detecting subgroups of IBD and offering them the right treatment. The most suitable treatment can be different for each patient with IBD.

This study is unique. Thanks to this study, we can discover traveller's IBD at the source, even before people change their lifestyle or diet. This gives us very pure results. We know that the onset of IBD after an intestinal infection is really related to the change in the microbiome in travellers. This finally allows us to unravel the role of the microbiome in IBD. This research has never been done like this before, and certainly not on such a large scale. We are working with 2000 travellers and have over 10,000 stool samples.’

Why is it important that the donor gives money for this research?

IBD is a condition that affects many people, but about which we actually know very little. It is not just ‘a bit of stomach ache’: the symptoms can be very serious. For a large group of people it really affects their daily life. They cannot go to work or school normally, and that has a significant impact. Yet very little research funding goes to IBD and that is not right. It is precisely because there is still so much knowledge lacking about this condition that we can make great strides through research. It would be fantastic if we could make a better diagnosis and realise a targeted treatment.’

Why is it important that the donor gives money for this research?

IBD is a condition that affects many people, but about which we actually know very little. It is not just ‘a bit of stomach ache’: the symptoms can be very serious. For a large group of people it really affects their daily life. They cannot go to work or school normally, and that has a significant impact. Yet very little research funding goes to IBD and that is not right. It is precisely because there is still so much knowledge lacking about this condition that we can make great strides through research. It would be fantastic if we could make a better diagnosis and realise a targeted treatment.’