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Novel genetic test predicts severity of IBD in children
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A genetic test developed to characterize intestinal microbiota may help to diagnose inflammatory bowel disease and predict the severity of the disease in children, enabling them to receive early, aggressive intervention when necessary, according to data presented at The European Society for Pediatric Gastroenterology, Hepatology and Nutrition annual meeting.
“IBD is often far more aggressive in children than it is in adults, but it is very difficult to predict the individual disease course,” Christine Olbjørn, MD, from the department of pediatric and adolescent medicine at Akershus University Hospital in Oslo, Norway, said in a press release. “We and other researchers are interested in the potential of fecal microbiota profiling to help us diagnose and manage these children and we have been helped by the availability of new genetic tests that can quantify different bacterial species in the gut.”
Researchers collected fecal samples from 235 children and adolescents aged 2 through 18 years in Norway, of whom 80 had Crohn’s disease, 27 had ulcerative colitis, 3 had unclassified IBD, 50 had symptoms but no IBD diagnosis, and 75 were healthy. They analyzed the samples using the novel GA-map IBD Dysbiosis Test (Genetic Analysis AS), an advanced DNA profiling test that can identify up to 300 different bacteria on different taxonomic levels. Researchers then compared the probe signal intensity (PSI), which indicates the abundance of different bacterial species, of the 3 groups: patients with IBD, non-IBD patients and healthy children.
The results showed that the children with IBD and those with symptoms but no IBD experienced significantly reduced PSI compared with the healthy children (P < .001). Patients with IBD experienced a reduced abundance of Firmicutes, Tenericutes and Bacteroidetes, and Bifidobacterium compared with the non-IBD symptomatic patients. Children with CD had an overall reduced diversity compared with patients with UC, but only reached statistical significance for Mycoplasma, where patients with CD had lower abundance (P = .045). Compared with patients with limited IBD, those with extensive disease had more Clostridiales (P = .02) and those with excessive CD had more Proteobacteria (P = .04). Of the 110 children with IBD, 64 children who later received biologic therapy with tumor necrosis factor (TNF) blockers had lower density at baseline for Firmicutes, Tenericutes and Bacteroidetes (P = .015) compared with the 46 children who were treated with conventional medications.
“We found that the probe signal intensity … was significantly reduced in the children with IBD and those with symptoms, but no IBD, compared to the healthy children,” Olbjørn said. “Our findings suggest that fecal microbiota profiles may be used to identify which children are destined for a more severe form of IBD and which, therefore, need more intensive monitoring and possibly earlier, more aggressive treatment.” – by Savannah Demko
References:
Olbjørn C, et al. Abstract #G-O-058. Presented at: ESPGHAN Annual Meeting; May 10-13, 2017; Prague, Czech Republic.
Disclosure: Healio Gastroenterology was unable to confirm any relevant financial disclosures at the time of publication.