Maarten Cozijnsen

145 Chapter 7 General discussion Translational medicine requires interdisciplinary collaboration Within the field of CD, the most important research questions concern the disease pathogenesis, the immunological responses to the various CD treatments, the underlying immune responses that result in endoscopic remission and biological markers that can predict endoscopic remission or treatment response in a broader sense. Further insight on these topics can significantly improve CD treatment. Translational research is pivotal to provide this insight. The critical factor for successful translational medicine is effective interdisciplinary collaboration. According to the European Society for Translational Medicine (EUSTM), translational medicine is created through a collaboration between the three main pillars benchside, bedside and community. 28 The benchside pillar stands for laboratory discoveries translated into practical clinical applications that benefit patients, the bedside pillar for returning clinical findings to research labs to redefine or create new hypothesis- driven research, and the community pillar for healthy populations, patients and medical practitioners that can provide valuable input to translational research. This interdisciplinary collaboration is challenging since in general, the two disciplines – basic research and clinical research – tend to use different study designs, but also differ in many other aspects such as language, culture, interests, research tools and resources. Furthermore, in most universities and research institutes, basic research and clinical research are conducted in separate departments. ITSKids and TISKids were designed to study differences in the immune responses of newly diagnosed pediatric CD patients to infliximab, prednisolone and/or exclusive enteral nutrition treatment. Both clinical and basic researchers actively worked together on designing an optimal yet feasible trial within the financial budget. Our pilot analyses revealed several genes in blood leukocytes and serum proteins associated with infliximab treatment initiation and with endoscopic remission ( Chapter 4 ). Performing these analyses within the larger TISKids cohort will further substantiate these results by the increase in statistical power. Furthermore, it will allow for subgroup analyses, such as comparison between patients that did and did not achieve endoscopic remission within the different treatment groups, and thereby lead to a deeper understanding of the immune responses that drive mucosal CD inflammation.