Summary
post-operative disease, cancer, IBD, Crohn’s disease
CANCER, DISEASE, RECURRENCE
Detailed study of the circulating DNA methylome in adults with new and established Crohn’s disease undergoing surgery within a large randomized controlled trial. Methylation alterations are observed in patients with post-operative disease recurrence.DNA methylation is an important epigenetic mechanism that associates with alteration in gene expression with no underlying change in the genetic code. DNA methylation changes have been implicated in cancer; agingIn our original studies, we described the circulating “methylome” in patients with IBD and control subjects,Although genome-wide methylation differences have been demonstrated between IBD cases and control subjects, identifying methylomic differences between IBD subphenotypes is more nuanced. Multiomic data have also been used to prognosticate in IBD, attempting to delineate patients at risk of severe disease phenotype requiring surgery or more intensive drug regimens.Patients with CD have a high lifetime risk of surgery for refractory or complicated disease. Approximately half of patients undergo surgery within 10 years of diagnosis;The coprimary aims of the present study were to determine whether circulating DNA methylation differences in patients before surgery differ between patients with and without evidence of clinical or endoscopic recurrence following surgical resection; and to extend our observations of methylation alterations made in inception cohorts of newly diagnosed patients by studying an independent cohort of patients with established CD requiring surgery (