Crohn’s Disease May Be Detectable Years Before Symptoms

Researchers at Sinai Health have discovered a blood test that can spot the warning signs of Crohn’s disease years before symptoms begin. Credit: Shutterstock Flagellin antibodies are elevated in a subset of individuals with genetic predisposition to Crohn’s disease, raising hopes of early detection and potentially prevention. Credit: Colin Dewar, Sinai Health A blood test may detect Crohn’s disease years before it strikes-changing how the condition is predicted and prevented. Researchers at Sinai Health have identified a blood test that can signal the risk of Crohn’s disease years before symptoms begin. The discovery raises the possibility of earlier diagnosis and, eventually, prevention for a condition that is often detected only after significant intestinal damage has occurred. How the Blood Test Works The test looks for an immune response to flagellin, a protein found on certain gut bacteria. According to a research team led by Dr. Ken Croitoru, a clinician scientist at the Lunenfeld-Tanenbaum Research Institute at Sinai Health, this immune response is unusually high in some people long before Crohn’s disease develops. The team included gastrointestinal medical resident Dr. Richard Wu and clinician scientist and staff gastroenterologist Dr. Sun-Ho Lee. Drs. Croitoru and Lee are also members of Mount Sinai Hospital’s Center for Inflammatory Bowel Disease (IBD), an internationally recognized hub for inflammatory bowel disease research. The findings were published in Clinical Gastroenterology and Hepatology and point to the interaction between gut bacteria and the immune system as a key early step in the development of Crohn’s disease. Why Crohn’s Disease Is a Growing Concern Crohn’s disease is a long-lasting inflammatory disorder of the digestive tract that can cause ongoing digestive problems, pain, and fatigue. These symptoms can seriously affect daily life. Rates of Crohn’s disease in children have doubled since 1995, and the overall number of cases continues to increase. Crohn’s and Colitis Canada, a non-profit organization focused on curing inflammatory bowel disease, estimates that about 470,000 Canadians will be living with IBD by 2035. Immune Signals Appear Long Before Symptoms Finding antibodies to flagellin years before symptoms start suggests that this immune reaction may play a role in triggering Crohn’s disease rather than simply appearing after the disease has begun, Dr. Croitoru explained. He believes that learning more about these early changes could lead to better ways to predict, prevent, and treat the condition. “With all of the advanced biologic therapy we have today, patients’ responses are partial at best. We haven’t cured anybody yet, and we need to do better,” said Dr. Croitoru, who hold Canada Research Chair in Inflammatory Bowel Diseases. The GEM Project and Early Disease Tracking This work is part of the Genetic, Environmental and Microbial (GEM) Project, a large international study following more than 5,000 healthy first-degree relatives of people with Crohn’s disease. Led by Dr. Croitoru, the project has been collecting genetic, biological, and environmental information since 2008 to better understand how Crohn’s disease begins. So far, 130 participants have gone on to develop the disease, giving researchers a rare chance to...

Preview: ~500 words