Circadian Misalignment as a disease risk factor in Inflammatory Bowel Disease

Crohn's Disease (CD) and Ulcerative Colitis (UC), collectively known as inflammatory bowel disease (IBD), are two of the most significant chronic conditions of the gastrointestinal tract (GIT). IBD is typically diagnosed at an early age, has no known cure, and has a chronic relapsing and remitting disease course that includes disabling symptoms during periodic flare ups. IBD affects over 1.5 million individuals in the US with an estimated direct cost of $6.1 billion.(1) IBD has a highly variable disease course, and identifying factors to avoid disease flare is essential to avoid complications such ashospitalization and surgery. Recently there has been compelling evidence that IBD subjects commonly have disrupted sleep, and disrupted sleep leads to a more aggressive disease course.(2, 3) Sleep and multiple biological processes in the body are orchestrated by the central circadian clock located in the suprachiasmatic nucleus. We have shown that disruption of the light:dark cycle, or circadian misalignment, can be a risk factor for increased intestinal permeability, dysbiosis, and mucosal inflammation, all of which are known risk factors for disease flare in IBD. However, whether circadian misalignment is prevalent in IBD or if it is a factor in promoting disease flare is a gap in our current knowledge. Microbiome analysis will be conducted to determine these primary outcome measures.