Inflammatory Bowel Disease (IBD) is a painful chronic condition causes by inflammation inside the digestive tract. Currently, diagnosis is made after the onset of symptoms, using invasive tests and treatment involves various drugs that require constant review and alteration. The unremitting, flaring nature of the disease and frequent doctor’s appointments dramatically change patient’s lives, as well as costing the NHS £3bn a year.
How to detect IBD before the onset of symptoms is poorly understood, however a recent study has found changes in antibodies can be detected 10 years before patients are diagnosed with IBD. The study looked at 2,000 blood samples from a cohort of military personnel in the US who had given blood as part of their service. Out of the 2,000 soldiers, 200 developed Crohn’s disease and 200 developed Ulcerative Colitis (subsets of IBD). Elevated antibodies from the Epstein-Barr Virus – the cause of glandular fever – were found in the patients who developed Crohn’s. Meanwhile autoantibodies, antibodies which mistakenly attack normal tissue, targeting MADD – a normal body protein – were found in patients with Ulcerative Colitis.
This suggests early immune dysregulation is strongly linked to the development of IBD and gives a framework for investigations into early pathogenic mechanisms. Increased understanding of what causes IBD will allow for the creation of preventative treatments which could reduce the severity and burden of disease.
More research is required going forward to provide supportive data for the hypothesis that the increase in immune dysregulation is the cause of IBD, not a consequence of disease development. However the fact that increases in antibodies were detected 10 years before diagnosis is a strong indicator for exposure preceding causation. Overall, this is a positive move towards catching IBD earlier, hopefully improving the future lives of hundreds of thousands of patients.
