In another prospective inception cohort study of paediatric patients with newly diagnosed CD in the United States and Canada, genotypes, ileal gene expression, antimicrobial serology, and ileal, rectal, and faecal microbiota were assessed in order to create a risk model for disease complications and efficacy prediction of subsequent anti-TNF therapy (Kugathasan et al., 2017). Here, TNF is linked to Cowden disease.