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A test that can diagnose Crohn’s disease before symptoms appear

Getting treatment for inflammatory bowel diseases can be a slow and arduous process. Querying the immune system could reveal answers faster.

Health

Inflammatory bowel disease (IBD) is a chronic inflammation disorder involving the intestinal tract. More than 200 000 new cases of it are diagnosed in the United States and Europe every year, and approximately 7 million people worldwide are affected by the illness. It is difficult to diagnose, and there is no cure. The EU-funded IBDetect project focuses on a world-first diagnostic system of the same name. This test can accurately diagnose both major forms of IBD, Crohn’s disease and ulcerative colitis, even before symptoms arise.

Faster diagnosis

“Currently doctors use a rule-one-out diagnosis, they do various blood tests, imaging tests, colonoscopies, to identify if there’s inflammation present, and where,” notes IBDetect project coordinator Christof Neuman. As well as being uncomfortable and carrying a risk of gastrointestinal perforation, this lengthy process results in delays to treatment and adversely affects the patient’s well-being. IBDetect is a rapid, minimally invasive and low-cost test that looks for evidence of disease reflected in the immune response as it responds to changes in the gut microbiome. “We have a proof of concept showing antibody signatures are unique for ulcerative colitis and Crohn’s disease,” adds Neuman, who works as director of business development at IPDx, the IBDetect project host.

Case history

The immune system monitors the body at all times, watching for threats from viruses, bacteria, our own cells, and other pathogens. This means the presence of any disease should be reflected here. “The immune system allows you to track illness in the body,” explains Neuman. “We may not be sure of the cause of the disease, but if it changes the expression of even one protein, the immune system will reflect it, and we can measure that.” In fact, IPDx screens in excess of a billion antigens to build a picture of what is happening inside the body. “This allows us to identify a clinically relevant biomarker panel,” he says. In the case of IBDetect, this is a checklist which can be compared to the expected changes in cases of Crohn’s disease or ulcerative colitis. As he explains, this test will not make clinical investigations obsolete, but will support doctors in making their decisions. It would also allow patients to receive a diagnosis faster than is currently possible.

Precision medicine

The project was supported by the EU’s Horizon 2020 programme. “We had this early data and an idea, and this funding allowed us to validate that idea and begin building a business case around it,” notes Neuman. Next, as well as applying for an EIC Accelerator grant to develop IBDetect to obtain a CE mark, Neuman says IPDx will work to create more diagnostic tests covering a range of applications in oncology, autoimmune diseases and patient responses to various drugs. “We are at a tipping point for medical innovation, where the more you can combine data from proteomics, genomics, the immune system and more, the closer you get to this area people call precision medicine,” adds Neuman. “That is what drives me, to provide that one critical element which will enable it.”

Keywords

IBDetect, inflammatory, bowel, Crohn’s, ulcerative, colitis, IPDx, immune, gastrointestinal

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