Serum antibodies, proteins may be predictive of Crohn’s disease

The serum profile of antibodies and proteins may help identify patients at risk of developing Crohn’s disease (CD) within 5 years, a new study reports.

The study included serum samples from 200 patients with CD and 199 with ulcerative colitis (UC). Using the appropriate assays, researchers measured antibodies against common microbes, as well as the levels of 1,129 proteins in each sample. A parallel batch of 200 samples from healthy individuals was also included.

Several antibodies were tested for perinuclear anti-neutrophil cytoplasmic antibodies (pANCA), anti-Saccharamyces cerevisiae antibodies immunoglobulin A and G, anti-Escherichia coli outer membrane porin C, and various anti-flagellins antibodies. At each yearly interval prior to diagnosis, titres of these were significantly elevated in CD patients than in controls, except for pANCA.

In addition, 51 protein biomarkers were found to be significantly predictive of the development of CD. Combined, the resulting area under the curve (AUC) 5 years before diagnosis was 0.76. This climbed to 0.88 a year before being diagnosed with CD.

Pathway prediction models showed that the development of CD may be associated with changes in glycosaminogen metabolism, lysosomes, the complement cascade, and innate immunity.

In comparison, using biomarkers to predict UC development had lower accuracy, with an AUC of 0.56 5 years before diagnosis, and 0.72 a year prior.

“Our results should be validated in independent populations, and the performance of our predictive tool should be improved with genetic, microbiome, and relevant clinical data (eg, smoking, family history) obtained from ongoing longitudinal cohorts,” the researchers said.

“Such multi-dimensional predictive tools could be used in prospective studies or disease prevention trials to select a priori populations at high risk for developing inflammatory bowel diseases,” they added.