Scientific Drivers for Diplomacy The China Syndrome
John I Allen MD, MBA, AGAF President: American Gastroenterological Association
Clinical Chief of Digestive Diseases - Yale University
The Science
East Meets West: The rising incidence of IBD in Asia as a paradigm for
environmental effects on the pathogenesis of immune-mediated diseases
Scientific Advisory Board for the AGA Center for Gut Microbiome for
Research and Education
Inflammatory Bowel Disease
Chronic inflammatory conditions of the digestive track Traditionally associated with… Western industrialized nations Caucasians from Northern, Central or Eastern Europe Ashkenazi Jewish people Immigrants to high risk regions
Etiologies and Treatments based on White Populations Incidence increasing in ethnicities and populations in whom these diseases were historically rare Mirrors experience in the West from 60 years ago
The Opportunity: Changing Epidemiology of IBD
..
Ouyang Q. Falk Symposium http://www.drfalkpharma.com/fileadmin/media/praesentationen/fs1
63/S1_P4.pdf
Loftus EV. Gastro 2004; 126:1504
Yang SF Inflamm Bowel Dis. 2001; 7:260
USA 1950’s
Japan 1970’s
China - Now
Inflammatory Bowel Disease – The Basics
Ulcerative Colitis Crohn’s Disease
1-2 per 1000
“How to Light a Fire in the Body”
Wajahat Mehal - Scientific American. June 2015
Theories “Westernization” of low incidence regions alters the microbiome and in people with a permissive genotype triggers chronic inflammation
Kostic AD et al. Gastroenterology 2014; 146:1489
Chassaing B and Darfeuille-Michaud A. Gastroenterology 2011; 140:1720
Sample Management
Kostic AD et al. Gastroenterology 2014; 146:1489
The Diplomacy
Yunsheng Yang MD – President Chinese Society of Gastroenterology
John Allen MD – President American Gastroenterological Association
October 2014 3-year Memo of Understanding to Build Scientific Partnerships
Confluence of Favorable Factors (With a Caveat)
AGA: • International Committee • Professional Conferences
• National GI Meetings • Mutual Support for Young
Investigators • Center for Gut Microbiome
China: • 4 Phases (Blumenthal and Hsiao) • Medical Societies • Young Investigators • Hospital Governance and Staff • Rise of Middle and Upper Classes • Cultural Differences Remain
Funding: • Pharmaceutical and Medical Device Companies • Philanthropic Foundations
• Sir Run Run Shaw - Hangzhou, China • Fox Chase Cancer Center: Academic Network MOU
Blumenthal D, Hsiao W. Lessons from the East – China’s Rapidly Evolving Health Care System. New England Journal of Medicine. 2015; 372:1281
Conclusion: Can Science Drive Diplomacy?
Scientific tools available Next Gen Sequencing Big Data – Registries
Changing Face of Medicine in China AGA’s Focus on International Medicine Favorable Funding Pharmaceutical and Medical Device American and Chinese Foundations