A Few Spanish Pearls for the American Journal of Gastroenterology.
TL;DR: How “cost-zero” research in Spain combined with international competitive pressure created a strong collaboration of independent support networks through researcher associations and societies is described, and how this collaboration has become one of the most important contributors to Spanish Gastroenterology.
Abstract: In the Red Section of this issue of the American Journal of Gastroenterology , well-known specialists in their respective fi elds present highlights from gastroenterology research in Spain. Th ese reports illustrate how well-organized network collaborations could impact the scientifi c literature worldwide, as these collaborations are positioned at the frontier of knowledge and could reveal innovative approaches to the diagnosis and treatment of patients with digestive diseases. Th ese achievements are especially notable, given that they occurred during a serious worldwide economic crisis that aff ected research in many countries, especially those that do not generally prioritize science ( 1,2 ). Most of the successes presented here were obtained under the umbrella of two national organizations. One is the CIBERehd, an acronym of the Spanish name “Centro de Investigation Biomédica en Red para Enfermedades Hepáticas y Digestivas” or “Biomedical Research Networking Center Consortium in Hepatic and Digestive Diseases” in English. Th e CIBERehd ( http://www.ciberehd. org ) is part of a larger entity known as “CIBER”, which has additional areas of interest focused on a variety of human diseases. Th e CIBER was initiated and organized by the National Institute of Health Carlos III ( http://www.eng.isciii.es ), in charge of coordinating Spanish biomedical research. Th e CIBERehd is a “virtual” center, combining the eff orts of the best research groups in gastroenterology and hepatology across the country, and it funds, awards, and prioritizes collaborative research among the groups. Th e second organization may have even greater merit in this context, and is known as the Asociación Española de Gastro enterología (AEG) ( http://www.aegastro.es ), also known as the “Spanish Association of Gastroenterology” in English. Th e AEG has promoted important network research collaborations joining the eff orts of many clinical research groups of diff erent sizes and capacities. Many of these groups are not yet included in the CIBERehd, which limits their capacity for funding. Th e AEG has several working groups (Esophagus-Stomach-Duodenum, GI Oncology, Endoscopy, Neuro-gastroenterology and Motility, Infl ammatory Bowel Diseases, Pancreas and Biliary Tree) and platforms and collaborates closely with other scientifi c organizations, including the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (GETECCU) with its registries and methodological unit, as well as the Spanish Pancreatic Club. In just 10 years, CIBER investigators have published >7200 articles in the top medical journals, and almost 2600 of them were related to CIBERehd. Th e AEG groups have published almost 300 studies over the same period, fi ft y of which have been published in Th e American Journal of Gastroenterology ( 3,4 ). One of the fi ve reports published in this special section illustrates two of the tools enabling this small miracle, the ENEIDA (Estudio Nacional en Enfermedad Infl amatoria intestinal sobre Determinantes genéticos y Ambientales) and the AEG-REDCap platforms. Adrian G. McNicholl and Javier P. Gisbert describe how “cost-zero” research in Spain combined with international competitive pressure created a strong collaboration of independent support networks through researcher associations and societies, and how this collaboration has become one of the most important contributors to Spanish Gastroenterology. ENEIDA, created by GETECCU, is a nationwide, hospital-based registry and biobank of Infl ammatory Bowel Disease patients from 100 Spanish hospitals. Th is database provides an infrastructure for the development of multicenter studies of all types. Th e impact and success of ENEIDA has grown exponentially and has become an inspiration for other European organizations replicating this model. Th e other major platform is the AEG-REDCap, created by AEG within a consortium agreement with Vanderbilt University ( 5 ). AEG-REDCap provides scientifi c methodological support and online data capture/management tools to over 50 projects, including more than 200 databases and 1300 researchers. Th e success of this initiative inspired participation by many European researchers in this local Spanish platform. Th e European Registry on Helicobacter pylori management is the best example of this success as well as the largest international project, with over 25,000 cases already registered. In the pages that follow, Enrique Quintero and Antonio GimenoGarcía off er a perspective on colorectal cancer screening based on studies conducted in Europe in general, and Spain in particular. Much of that knowledge was again obtained within the collaborative network of the GI Oncology group of AEG. Th is AEG working group has effi ciently and successfully generated ongoing projects, A Few Spanish Pearls for the American Journal of Gastroenterology
Summary (1 min read)
- Including the EPICOLON (estudio de la EPIdemiologia del cáncer de COLON) I and II as well as COLONPREV (COLON PREVention study), which have already resulted in important reports.
- Th e COLONPREV project ( 6 ) will be the fi rst RCT to provide 10-year mortality data, comparing colonoscopy and biennial FIT, as screening methods for intermediate risk populations over the age of 50.
- Th e EST-CPRE study, a retrospective analysis of consecutive patients undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP) in four centers in Spain, found that patients consuming statins had a 70% lower risk of post-ERCP acute pancreatitis.
- Crucially, these studies have advanced the understanding that GERD and EoE are not mutually exclusive disorders, and that there is a clear EoE phenotype with complete remission on PPIs, with or without GERD.
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