A new blood test could predict Crohn’s disease years before symptoms manifest, offering hope for earlier diagnosis and prevention, according to Canadian researchers.
Canadian researchers have developed a promising blood test that may detect Crohn’s disease years before symptoms appear, potentially enabling earlier diagnosis and prevention of this chronic inflammatory bowel disease (IBD).
The test measures the immune system’s response to flagellin, a protein found in gut bacteria. Researchers discovered that this immune response is elevated in some individuals years prior to the onset of Crohn’s disease.
The findings, published in the journal Clinical Gastroenterology and Hepatology, emphasize the significant interaction between gut bacteria and immune system responses as a crucial factor in the disease’s development.
Crohn’s disease is a chronic inflammatory condition affecting the gastrointestinal tract, leading to persistent digestive symptoms, pain, and fatigue. It has a profound impact on quality of life, and its incidence among children has doubled since 1995, according to official statistics.
Dr. Ken Croitoru, a clinician-scientist and professor of medicine and immunology at the University of Toronto, led the research. He noted that the presence of flagellin antibodies long before symptoms appear suggests that the immune reaction may play a role in triggering the disease.
“With all the advanced biologic therapy we have today, patients’ responses are partial at best,” Croitoru stated. “We haven’t cured anybody yet, and we need to do better.”
The research team aimed to determine whether healthy individuals at risk for Crohn’s disease had antibodies against flagellin. Their findings confirmed that at least some of these individuals did possess such antibodies.
This study is part of the Genetic, Environmental and Microbial (GEM) Project, which has been monitoring over 5,000 healthy first-degree relatives of Crohn’s patients worldwide since 2008. The project collects genetic, biological, and environmental data to gain a better understanding of how Crohn’s disease develops.
In this particular study, researchers followed 381 first-degree relatives of Crohn’s patients, 77 of whom later developed the disease. Among those who developed Crohn’s, more than 30% exhibited elevated antibody responses to flagellin. The responses were notably stronger in siblings, highlighting the influence of shared environmental factors.
To date, 130 participants in the GEM Project have been diagnosed with Crohn’s disease, providing researchers with a unique opportunity to investigate the disease’s earliest stages. The average duration from blood sample collection to diagnosis was nearly two and a half years.
Previous research from the GEM Project indicated that an inflammatory immune response targeting gut bacteria could manifest long before the disease itself develops. In healthy individuals, gut bacteria coexist harmoniously and are essential for digestive health. However, in those with Crohn’s disease, the immune system appears to react abnormally to these microbes.
The Canadian research team also confirmed that this pre-disease immune response correlates with intestinal inflammation and gut barrier dysfunction, both of which are characteristic of Crohn’s disease.
Dr. Sun-Ho Lee, a gastroenterologist and member of the research team, suggested that the findings support the potential development of a flagellin-directed vaccine for high-risk individuals to prevent the onset of Crohn’s disease.
However, the study does have limitations. It did not include experiments to clarify how the immune response may lead to Crohn’s disease, leaving the biological steps linking the immune reaction to the onset of the illness undetermined. The researchers acknowledged that “further validation and mechanistic studies are underway.”
As research continues, the hope is that these findings will lead to improved prediction, prevention, and treatment options for Crohn’s disease, ultimately enhancing the quality of life for those at risk.
According to SWNS, this innovative approach could mark a significant advancement in understanding and addressing Crohn’s disease.