Diseased colon, illustration

A team of international scientists lead by the University of Toronto have discovered an autoantibody detectable in blood that can be used as a biomarker to predict complicated Crohn’s disease up to seven years prior to diagnosis.

The underlying mechanisms of Crohn’s disease, a type of Inflammatory Bowel Disease and an increasingly diagnosed serious health issue worldwide, are not yet completely understood. Although more and more people are suffering from the disease, effective biomarkers which could be used prior to diagnosis are still sought after. A new study, published in Gastroenterology could be about to change this.

“Our team identified a serological biomarker for Crohn’s disease that also participates in its pathogenesis and occurs years before the disease shows its full clinical spectrum,” says Arthur Mortha, first author of the study and assistant professor of immunology at the University of Toronto´s Temerty Faculty of Medicine in a press statement.

The biomarker is an autoantibody produced by gut cells, anti–GM-CSF autoantibodies, which prevent communication among intestinal immune cells by blocking the function of a cytokine protein responsible for gut immunity. In order to identify the biomarker, the researchers used blood samples collected annually over a decade from hundreds of people that eventually developed Crohn’s disease and compared them to healthy controls.

Blood tests have been used in connection with Crohn’s disease diagnostics in the past. In an earlier review article published in Frontiers in Medicine, several blood biomarkers already linked to inflammatory bowel disease, were compared to one another. However, none of the serum biomarkers were found to be ideal for Crohn’s disease diagnostics.

In this study, Mortha and colleagues were able to show that anti–GM-CSF autoantibodies disrupted gut immunity in a quarter of Crohn’s patients. This change was detectable in the patients’ blood several years before disease diagnosis and resulted in severe cases of the autoimmune condition. The researchers believe this is a discovery that may be used for developing specific blood tests, enabling earlier disease diagnosis and preventing chronic inflammation while remaining a fast and non-invasive method.

Mortha and colleagues are also working on potential therapeutic approaches for the condition by creating modified versions of the autoantibody target. “Our system allows us to see how the antibodies in each patient specifically neutralize the cytokine. We are now engineering cytokines that can escape neutralization by these antibodies in individual patients,” Mortha says in a press statement.

This approach could be used in highly personalized therapies aiming to reduce the negative effects of the autoantibody on gut immunity and potentially reducing severity of the condition in patients.

“The past decade has taught us a lot about the modes of communication used by our gut immune cells to establish a healthy balance… It is now time to bring what we have learned to use,” Mortha concludes in a press statement.

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