Serum Biomarker Panel May Help Predict Crohn’s Diagnosis
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A panel of serum antibodies and proteins helped identify patients who later received a diagnosis of Crohn’s disease within 5 years, according to research published in Gastroenterology.
Jean-Frederic Colombel, MD, PhD, of the Icahn School of Medicine at Mount Sinai, and colleagues wrote that inflammatory bowel disease appears to be like other immune-mediated diseases, in that it is proceeded by an asymptomatic, pre-clinical period.
“Gaining insight into this phase could allow disease prediction,” they wrote. “The PREDICTS (Proteomic Evaluation and Discovery in an IBD Cohort of Tri-Service Subjects) study was initiated with the goal of identifying biomarkers associated with IBD onset, by using preclinical serum samples stored in the United States Department of Defense Serum Repository [DoDSR].”
Researchers obtained serum samples from the DoDSR from before a diagnosis of CD (n = 200), ulcerative colitis (n = 199) and healthy controls (n = 200) collected between 1998 and 2013. They measured antibodies against microbes (anti-Saccharomyces cerevisiae IgA or IgG, anti-Escherichia coli outer membrane porin C, anti-CBir1, anti-flagellin 2, anti-flagellin X, and perinuclear anti-neutrophil cytoplasmic antibodies) and more than 1,100 proteins per sample. Investigators analyzed the samples to provide a time-varying trajectory for each marker, which were then used to predict disease status.
In their analysis, investigators identified a panel of 51 protein biomarkers that were predictive of CD within 5 years with an area under the receiver operating characteristic curve (AUROC) of 0.76 and a diagnosis within 1 year with an AUROC of 0.87.
Using these proteins, researchers found that imminent development of CD was associated with changes in the complement cascade, lysosomes, innate immune response and glycosaminoglycan metabolism.
Colombel and colleagues wrote that their work represents a critical foundation for future research on the asymptomatic, pre-clinical phase of CD.
“IBD prediction and prevention may be a possibility in the future, and it is clear that further research in this field is warranted,” they wrote. “In the future, early identification of individuals at high-risk for disease development could allow for close monitoring and for the development of interventions to delay, attenuate or even halt disease initiation.” – by Alex Young
Disclosure: Colombel reports receiving research grants from AbbVie, Janssen Pharmaceuticals and Takeda; receiving payment for lectures from AbbVie, Amgen, Allergan Inc. Ferring Pharmaceuticals, Shire, and Takeda; receiving consulting fees from AbbVie, Amgen, Arena Pharmaceuticals, Boehringer Ingelheim, Celgene Corporation, Celltrion, Eli Lilly, Enterome, Ferring Pharmaceuticals, Genentech, Janssen Pharmaceuticals, Landos, Ipsen, Medimmune, Merck, Novartis, Pfizer, Shire, Takeda, Tigenix; and holding stock options in Intestinal Biotech Development and Genfit. Please see the full study for all other authors’ relevant financial disclosures.
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