Professor Miles Parkes is Clinical and Research Collaboration Workstream Executive Lead at Gut Reaction. He is also a Consultant Gastroenterologist and inflammatory bowel disease (IBD) specialist at Cambridge University Hospitals, Chief Investigator of the NIHR IBD BioResource and Director of NIHR Cambridge Biomedical Research Centre (BRC).
We would like to thank Professor Parkes for finding time in his busy schedule to talk about his role in Gut Reaction, and why improving diagnostic and treatment options for people living with IBD is so important.
Professor Parkes, we can see from the list above that you hold a lot of roles, not only within Cambridge University Hospitals, but also research organisations. Please could you tell us what a typical day is like for you?
One of the great things about my job is that it’s really quite varied. A normal day might include clinical work with my patients living with ulcerative colitis and Crohn’s disease (known collectively as IBD) in outpatient and endoscopy clinics, and inpatient wards, alongside supervision and oversight of our ongoing research into IBD.
I am particularly involved in the work of Gut Reaction and the NIHR IBD BioResource, and also coordinate activities for the UK IBD Genetics Consortium. Our genetic research programme involves close collaboration with Carl Anderson and his team at the Wellcome Sanger Institute, aiming to understand some of the causes of IBD and to develop models that help predict how an individual’s IBD will behave and what treatments might be most effective in any given patient.
As Clinical Lead for Gut Reaction I oversee our collaboration with other NHS trusts, supporting the data gathering and helping ensure that all legal and ethical obligations for data sharing are met, while looking for research opportunities within the data. My role as Director of the NIHR Cambridge BRC also allows me to interact with researchers in other important health conditions, such as heart disease, COVID-19 and cancer.
How did you get involved with Gut Reaction, and why do you think it is needed?
There is a very active research community within IBD in the UK, and we have known for some time that Crohn’s disease, in particular, has a strong genetic influence. Our work has helped to identify some of the genetic markers that are associated with IBD, but in order to make this knowledge really useful for our patients we need to discover what these markers mean for disease severity, response to treatment and long-term outcomes.
Just over five years ago, supported by Crohn’s & Colitis UK, the Medical Research Council and the National Institute for Health Research (NIHR), we set up the NIHR IBD BioResource. This has become a really valuable asset for IBD research; we now have more than 35,000 people with IBD participating by sharing specific health data and biological samples, and these numbers continue to grow. When the chance came to join up this information with data from NHS hospitals, genetic information from our research programmes with the Sanger Institute and records from the UK IBD Registry through Gut Reaction it was clearly a great opportunity.
Gut Reaction is unique as it offers researchers the opportunity to bring together powerful data from many different sources, allowing research that simply wasn’t possible before. One of the really positive outcomes is that because our patients have been so involved in setting up and directing Gut Reaction, we are now able to undertake studies that will have a direct impact on patient care and address the research questions that are important to the IBD community.
With Crohn’s and Colitis Awareness week in mind, what do you think are currently the key challenges for IBD patients and their healthcare teams?
A key challenge is knowing what is the right treatment for any given patient and providing them with this quickly. Not all patients respond to all treatments, and currently for people with more severe disease we may have to try a few options before we find one that works. This takes time, during which our patients feel poorly, and can increase the risk of problems and complications. Symptoms can be severe, can come on or deteriorate quite suddenly, and achieving the disease control to ensure our patients have a good quality of life isn’t always simple. Finding a way of identifying the treatment that would suit each individual patient, as early as possible in their disease course is something that we are all working towards.
There can also be quite a delay from patients first noticing symptoms, such as tummy pains or bloody diarrhoea, to receiving a diagnosis of IBD. This can be very distressing, and may result in their illness progressing further than we might have hoped. Quickly identifying those patients who are most at risk of progression is a real challenge, and one that we hope can be met through research programmes such as Gut Reaction looking for early markers of IBD or complications of the disease.
How can we, as a community supporting IBD research, best address these issues?
We have a real opportunity to learn more about IBD by looking at samples and information from patients who are newly diagnosed, before they have started treatment, and being able to compare these to samples taken after treatment.
I’d encourage anyone who has just received a diagnosis of Crohn’s disease or ulcerative colitis to think about joining the NIHR IBD BioResource for this reason. Our recent progress in genetics and safe use of patient heath data means that everyone can make a valuable contribution to IBD research in a way that doesn’t involve a big time commitment. This will be the best way to bring on new treatments and hopefully reduce the impact of IBD in the future.
Finally, is there any area of research that you think might be especially interesting for the IBD community in the coming year?
The COVID-19 pandemic has been really tough for many individuals with long-term conditions, including our IBD patients. We are fortunate to have several fantastic vaccines, but for patients receiving treatments for IBD that target their immune systems (known as ‘Immunosuppressants’ and ’biologics’) we still don’t know how much protection vaccination offers. This is where a resource like Gut Reaction is so important; we can join together all the patient information from the NIHR IBD BioResource with data from NHS hospitals to get a much clearer picture of how IBD patients are being impacted by COVID-19. Information like this will help us to ensure that we are making the right decisions to keep our patients safe and well during this very difficult time.
We’d like to thank Professor Parkes for his time, and for his crucial contribution to Gut Reaction.
- Find out more about our partners at the NIHR IBD BioResource and Crohn’s & Colitis UK.
- Crohn’s & Colitis Awareness Week is from December 1-7 2021: Share the hashtag #IBDVisible on your social media accounts and help raise awareness of Crohn’s & Colitis.
