decoding the clinical impact of host and microbial intestinal proteomic landscape in crohn's disease

Conditions: Crohn Disease

Summary: in this study, the investigators will explore our protein-based platform assessing commensals potentially contributing to features of cd, while assessing the global composition and abundance of amps expressed in the gi tract under specific cd-relevant clinical contexts. this would enable us to (a) identify new commensals contributing to features of cd spectrum and various sub-types; (b) uncover the mechanistic basis of dysbiosis in cd (c) utilize the pipeline to develop new theranostic for disease exacerbation, complication and treatment responses; and (d) potentially enable future exploitation of novel amp combinations, and their respective antimicrobial capacity to counteract dysbiosis in cd. uncovering the proteomic manifestations of perturbed host-microbiome communications in cd will eventually enable the development and validation of clinical non-invasive surrogate markers, mechanistically determine causative drivers of cd, and potentially facilitate the development of novel therapeutic interventions.

participants will be recruited from a community outpatient clinics and from a leading outpatient gastroenterology clinic: emek medical center, after icf signing , they will fill out a medical, demographic, and lifestyle habits questionnaires, as well as a food frequency questionnaire (ffq). participants will receive a home stool kit and will be instructed on how to use it. they will also receive a kit and an explanation regarding preparation materials for the colonoscopy. subjects will be asked to collect stool samples at home - prior to colonoscopy and if possible - after colonoscopy bowel prep. the seconed visit of the study will occure on the day of colonoscopy. each patient will be clinically assessed by a gastroenterologist using the crohn's disease activity index (cdai)30 and harvey-bradshaw index (hbi); and collection of luminal, brush cytology, and mucosal samples from 4 different lower intestine regions

Eligibility criteria:
inclusion criteria - cd study group: * age ≥ 18 * candidates for a medically-indicated, diagnostic colonoscopy due to suspected new-onset cd. * naïve to any medical or nutritional intervention. inclusion criteria - healthy controls: • age- and gender-matched patients to the cd group, admitted for non-specific gi complaints (such as changes in bowel movements, bloating, abdominal pain) or routine screening for colorectal cancer as part of primary prevention per clinical guidelines. exclusion criteria - both groups: * established diagnosis of inflammatory bowel disease (ibd) with prior treatment. * chronic gastro-intestinal disorder (e.g. celiac disease, eosinophilic esophagitis, collagenous gastritis, autoimmune gastritis, etc.). * type 1 or type 2 diabetes mellitus. * past or present history of malignancy. * bmi \> 30 (kg/m2) * use of systemic antibiotics or probiotics 2 months prior to enrolment. * use of steroids 2 months prior to enrolment (not including a short course of topical steroidal therapy). * any previous major gastric or intestinal surgery. * suspected or proven extensive involvement of non-ileal small intestine or colon, or significant perianal disease. * significantly stricturing or penetrating (fistulizing) disease at presentation. * chronic treatment with any oral/systemic immunosuppressive or anti-inflammatory drugs (e.g. steroids, 5-aminosalicylic acid, immunomodulators, biologics, etc.). patients receiving these drugs as inhalers/creams/ointments should not be excluded from the study. * primary immunodeficiency. * pregnancy or breastfeeding in the last 6 months. * serious medical conditions that may alter the gut microbiome composition, based on investigators judgement (for example primary immunodeficiency, autoimmune disorder, or rheumatologic disease).