Immune Circuits in Duodenal Polyposis of Familial Adenomatous Polyposis

Jacob Nattermann, MD

• Professor of Hepatogastroenterology and Head of the Section for Hepatogastroenterology,

• Deputy Director of the Department of Internal Medicine I at Bonn University Hospital

Immune Circuits in Duodenal Polyposis of Familial Adenomatous Polyposis

Familial adenomatous polyposis (FAP) is an inherited condition that causes hundreds of polyps to grow in the intestine. While surgery can prevent colon cancer, polyps in the duodenum remain a major cancer risk and a leading cause of death in FAP patients. The disease progresses very differently among individuals, even within the same family, suggesting that additional factors such as immune regulation and the gut environment play an important role.

This project will:

1. Create a detailed “cell atlas” comparing immune and epithelial cells in duodenal tissue from FAP patients with mild and advanced disease, revealing which cell types and pathways are linked to faster polyp growth.

2. Use advanced computer modelling to integrate these data and predict which immune circuits drive disease progression and could represent potential targets for prevention or therapy.

The resulting maps and predictive models will provide new insight into how the immune system influences duodenal tumor development in FAP and could guide future efforts to delay surgery or design mechanism-based prevention strategies