Air pollution and the bowel
Dr. Gilaad Kaplan's research on air pollutants provides insight into the causes of inflammatory bowel disease.
Story by Laura Ly/Photo by iStock
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a chronic and debilitating disease characterized by inflammation of the intestine. Alberta has one of the highest rates of IBD per capita in the world. The exact cause of IBD is unknown, but researchers believe that factors such as environmental exposure, diet, and genetic susceptibility may play roles. The disease emerged predominantly during the Industrial Revolution and is diagnosed more frequently in industrialized nations, leading researchers to question whether air pollutants may play an important role in its development. Enter Dr. Gilaad Kaplan, an IBD researcher at the University of Calgary.
"The incidence of IBD begins to rise as countries develop. My research looks at whether air pollution could potentially explain why this occurs," says Dr. Kaplan. He uses data from Alberta Health and Wellness to identify people who have been diagnosed with IBD in Alberta during the last ten years. "Using this data, we match IBD patients with people who don't have IBD but are of the same age and gender. We want to see if IBD patients were more likely to live in areas of higher air pollution concentration," he explains. Dr. Kaplan is particularly interested in exposure to traffic-related pollutants in urban areas.
The study also investigates whether air pollution can explain the variations in outcomes among patients. Some patients require hospitalization and surgery during the course of the disease; other patients only have mild to medium flare-ups. "We want to see if the prognosis of patients who live in areas of greater air pollution is worse than patients who live in areas of less air pollution. Can location and air quality explain the differences?"
In a previous study, Dr. Kaplan examined the relationship between air pollution and IBD using data from the UK. That study showed that children living in areas with higher concentrations of nitrogen dioxide—a compound associated with traffic-related pollutants—were more likely to be diagnosed with Crohn's disease. "This is the first epidemiological study to demonstrate that association between traffic pollution and Crohn's disease. I'm interested in whether the data from Alberta shows the same association. If that association between environmental factors and IBD is replicated using different data, we gain a better understanding of the mechanisms that may cause IBD," says Dr. Kaplan.
Dr. Kaplan is also a team member of the Alberta IBD Consortium—an interdisciplinary team, supported by Alberta Innovates – Health Solutions, aimed at studying how genes, environmental exposure, and microorganisms interact in the development of IBD.
"Our goal is to do a very comprehensive study of the interactions that may affect the development of IBD. It is very difficult for one individual to be able to understand and explore all aspects of a disease. As part of this team, I work with numerous individuals who bring in their own expertise and knowledge to look at this disease from different perspectives," explains Dr. Kaplan. "We know that neither genes nor environment alone will explain IBD, but being able to look at genetic susceptibility in relation to environmental exposure helps move our research forward."
A gastroenterologist by training, Dr. Kaplan also operates an IBD clinic in Calgary—a place where his research in the lab becomes especially relevant. "Seeing first-hand the effects of IBD on the lives of my patients motivates my research in the lab. My goal is to have a better understanding of what causes IBD so we can more effectively diagnose and treat it. My 'holy grail' objective is to find a way to prevent the disease entirely."