Profiling perianal fistulas (PPF)
Research type
Research Study
Full title
The immunological and metabonomic profile of perianal fistulas
IRAS ID
252059
Contact name
Phil Tozer
Contact email
Sponsor organisation
London North West University Healthcare NHS Trust
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
A perianal fistula is a tunnel connecting the anus to the skin around the buttock and causes distressing symptoms such as pain and discharge. Most are idiopathic, caused by a preceding abscess in the mucus glands in the anal canal, however they commonly occur in Crohn’s disease (CD), where the reasons for their onset are poorly understood. Patients who suffer from perianal Crohn’s fistula (pCD) are more likely to have severe and complicated disease, needing more operations and hospitalisations, and can suffer debilitating symptoms destructive to their work and social lives. Current treatment for CD is effective at treating fistulas, however only some patients respond and even fewer experience long term fistula closure. Fistulas can sometimes occur in Ulcerative Colitis (UC), either on their own or after pouch surgery. In each scenario, fistulas respond to different treatments and are likely to have different mechanisms behind them. The aim of this study is to understand more about what causes an abscess to develop into a fistula, why some fistulas persist despite treatment, what differentiates fistulas in each clinical group on a cellular and molecular level, and to understand why some fistulas in pCD respond to treatment, whilst others do not.
We will do this by conducting an observational study of patients with perianal abscesses, idiopathic, pCD, pouch, rectovaginal fistulas and fistulas in UC. The study will be conducted at London North West University Healthcare NHS Trust and will involve taking tissue, blood, urine and stool samples of patients with perianal abscesses and fistulas. We will investigate the presence of different cells in each group, and whether certain types of cells and cell products can be related to how well a patient responds to treatment. We will observe how fistulas behave clinically over time and patients will be observed over 24 months.
REC name
South West - Frenchay Research Ethics Committee
REC reference
19/SW/0024
Date of REC Opinion
7 Mar 2019
REC opinion
Further Information Favourable Opinion