Blood antibodies may reveal inflammatory bowel disease up to a decade before diagnosis, study finds
Researchers who screened 2,000 stored blood samples found immune 'warning signs' of Crohn's disease and ulcerative colitis years before symptoms. It is not yet a test, the scientists stress, but it could one day allow earlier treatment or even prevention.
The immune system may start sending warning signals about inflammatory bowel disease (IBD) up to ten years before people are diagnosed, according to new research that raises hopes of catching the condition before it damages the gut. Crohn's disease and ulcerative colitis, the two main forms of IBD, are usually treated only once symptoms appear.
Scientists at University Medical Centre Groningen, the Icahn School of Medicine at Mount Sinai in New York and the Medical University of Vienna examined 2,000 blood samples from 500 US military personnel. Of these, 200 later developed Crohn's disease, 200 developed ulcerative colitis and 100 developed neither. The samples were screened for antibodies against hundreds of thousands of protein fragments from bacteria, viruses, food and the body's own tissues.
In people who went on to develop Crohn's disease, antibodies against the Epstein-Barr virus, which causes glandular fever, were more common, and the difference was already visible a decade before diagnosis. The signal was strongest in those who later developed more severe, complicated disease. People who developed ulcerative colitis showed a different pattern, including antibodies against one of the body's own proteins.
'This is not yet a test that can tell someone they will become ill, but it is an important step towards catching the disease earlier and, one day, preventing it,' said lead researcher Dr Arno Bourgonje. The results, published in the journal Gut and presented at the United European Gastroenterology meeting in Barcelona, still need confirming in other groups and show a link rather than proof that the infections cause IBD. James Lindsay, a gastroenterology professor at Barts Health who was not involved, called the techniques 'very much a research tool', not yet ready for the clinic.
At least 3.8 million people worldwide live with IBD, which causes pain, diarrhoea and fatigue and raises the risk of bowel cancer. The researchers hope it could follow the path of type 1 diabetes, where blood tests can already flag people whose immune systems have begun attacking the body before symptoms start.
Source: The Guardian