Biomarkers Can Predict Inflammatory Bowel Disease Onset and Complications

Biomarkers are able to predict inflammatory bowel disease (IBD) development and complications, according to findings published in the journal Alimentary Pharmacology and Therapeutics.

Researchers from Mount Sinai’s Hospital and School of Medicine obtained serum samples from 100 US military personnel with Crohn’s disease (CD) to evaluate the pattern of serological antimicrobial antibodies prior to an IBD diagnosis and the subsequent risk of complications after diagnosis.

The samples were obtained through the Department of Defense Serum Repository at four different time points before, at, and after diagnosis. Then, the researchers tested the samples for six microbiota directed antibodies and assessed the differences between the presence and accumulations of CD anti-microbial antibodies before diagnosis and subsequent complications.

The study authors noted that the biomarkers had been shown for years to circulate in patients’ serum samples before IBD diagnosis and are linked to more severe disease when identified or shortly after IBD diagnosis. But this study is groundbreaking, because it is the first to demonstrate the markers and their progression through the use of multiple samples at different time points prior to IBD diagnosis.

Two thirds of the patients tested positive for at least one IBD biomarker in the earliest serum samples taken before the IBD diagnosis, the researchers reported. Plus, the number of positive markers (out of six) increased leading up to the diagnosis.

The individuals with more antibodies and higher titers developed more frequent complications around the time of their diagnosis, which ranged from the need for surgery to strictures to fistulae and abscesses, the authors said.

“These findings suggest that it may be possible to identify a population of patients not only at high risk for IBD, but also for complicated disease in which preventive strategies or intensive monitoring could be applied,” co-senior author Joseph A. Murray of the Mayo Clinic, said in a press release. “Further research into this stage of preclinical disease would likely lead to better understanding and identification of key events involved in disease pathogenesis.”

The future research will hinge on 2,500 serum samples from CD patients, ulcerative colitis patients, and control patients. The antimicrobial markers will be tested, but the researchers will also test for other preclinical markers such as proteomic profile and exposure to infectious agents like viruses.