New prognostic test could enable personalised treatment of inflammatory bowel disease

Scientists at the University of Cambridge have developed a new test that can reliably predict the future course of inflammatory bowel disease in individuals, transforming treatments for patients and paving the way for a personalised approach.

New prognostic test could enable personalised treatment of inflammatory bowel disease. Photo: NIAID

Ulcerative colitis and Crohn’s disease – collectively known as inflammatory bowel disease (IBD) – are chronic conditions that involve inflammation of the gut. Symptoms include abdominal pain, bloody diarrhoea, weight loss and fatigue.

There is currently no cure, but there are a growing number of medicines that aim to relieve symptoms and prevent the condition returning; however, the more severe the case of the IBD, the stronger the drugs need to be and the greater the potential side effects.

Researchers previously showed that a genetic signature found in a certain type of immune cell known as a CD8 T-cell could be used to assign patients to one of two groups depending on whether their condition was likely to be mild or severe (requiring repeated treatment). However, isolating CD8 T- cells and obtaining the genetic signature was not straightforward, making the test unlikely to be scaleable and achieve widespread use.

In the latest study, the researchers worked with a cohort of 69 patients with Crohn’s disease to see whether it was possible to develop a useful, scaleable test by looking at whole blood samples in conjunction with CD8 T-cells and using widely-available technology.

The team used a combination of machine learning and a whole blood assay known as qPCR – a relatively simple tool – to identify genetic signatures that re-created the two subgroups from their previous study.

The accuracy of the test is comparable to similar biomarkers used in cancer, which have helped transform treatment, say the researchers. They found the new test was 90-100% accurate in correctly identifying patients who did not require multiple treatments. (University of Cambridge)

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