Blood test flags digestive disease risk years before symptoms appear

A simple blood test may detect Crohn's disease years before symptoms appear, according to a new study reported by SWNS.

Canadian researchers say the discovery could enable earlier diagnosis and potential prevention of the chronic inflammatory bowel disease (IBD).

The test measures the immune system's response to flagellin, a protein found in gut bacteria. Researchers found that this response is elevated in some people years before Crohn's develops.

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The findings, published in Clinical Gastroenterology and Hepatology, highlight the "interplay" between gut bacteria and immune system responses as a key step in the disease's development, per the SWNS report.

Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract that causes persistent digestive symptoms, pain and fatigue, significantly affecting quality of life. Its incidence among children has doubled since 1995, according to official figures.

The presence of flagellin antibodies long before symptoms appear suggests that the immune reaction may help trigger the disease, according to research leader Dr. Ken Croitoru, clinician-scientist and professor of medicine and immunology at the University of Toronto. 

A better understanding of this early process could lead to improved prediction, prevention and treatment, the expert said.

"With all the advanced biologic therapy we have today, patients' responses are partial at best," Croitoru told SWNS. "We haven't cured anybody yet, and we need to do better."

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"We wanted to know: Do people who are at risk, who are healthy now, have these antibodies against flagellin?" he said. "We looked, we measured, and yes indeed, at least some of them did."

This new research is part of the Genetic, Environmental and Microbial (GEM) Project, which has followed more than 5,000 healthy first-degree relatives of people with Crohn's disease worldwide since 2008. The project collects genetic, biological and environmental data to better understand how the disease develops.

The study followed 381 first-degree relatives of Crohn's patients, 77 of whom later developed the disease. Of those, more than 30% had elevated antibody responses.

The responses were strongest in siblings, underscoring the role of shared environmental exposure, researchers said.

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So far, 130 of the study participants have developed Crohn's, giving researchers a rare opportunity to study its earliest stages. The average time from blood sample collection to diagnosis was nearly 2-½ years.

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Previous GEM research showed that an inflammatory immune response targeting gut bacteria can appear long before the disease develops. 

In healthy people, gut bacteria coexist peacefully and play an essential role in digestive health - but in Crohn's patients, the immune system appears to mount an abnormal response against the microbes, experts say.

The Canadian team also confirmed that this pre-disease immune response was associated with intestinal inflammation and gut barrier dysfunction, both hallmarks of Crohn's disease. 

Research team member Dr. Sun-Ho Lee, a gastroenterologist, commented that this new study supports the idea of designing a flagellin-directed vaccine for certain high-risk individuals to prevent the disease, according to SWNS.

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The study did have some limitations, including that it did not include experiments to show exactly how the immune response might lead to Crohn's disease. 

As a result, the researchers could not determine the biological steps linking the immune reaction to the onset of the illness. "Further validation and mechanistic studies are underway," they noted.