Public Release: 

New indicators to aid Crohn's disease diagnosis and treatment

Arizona State University


IMAGE: The diagnosis, understanding and management of Crohn's disease may have just received a helping hand from a joint ASU Biodesign Institute and Mayo Clinic study aimed at developing a better... view more

Credit: Biodesign Institute, Arizona State University



"If we are going to truly alter the natural history of Crohn's disease and help people, we needed to develop a new test for early, accurate diagnosis, as well as administrating appropriate therapy," said Josh LaBaer, the Biodesign Institute's interim executive director.

"We are particularly excited about the links between the immune response against self proteins and Crohn's disease, as this may give physicians a new avenue to explore both the potential cause and treatments," said LaBaer, who leads a team of 100-plus interdisciplinary scientists as director of the Virginia G. Piper Center for Personalized Diagnostics. Their broad vision focuses on the discovery and validation of biomarkers to provide early warning for those at risk of major illnesses, including cancer, autism and diabetes to improve patient outcomes.

The medical cause of Crohn's disease remains a mystery with no simple medical explanation or cure. But in the course of the disease, the body's own immune system is somehow triggered to attack the gut.

Knowing this, LaBaer and Qiu advanced a new approach, immunoproteomics, to broadly sift through the entire repertoire of immune system proteins in the blood and identify early bell weathers of Crohn's disease, the most common inflammatory bowel disease.


Crohn's diagnosis can be very difficult, and involves either expensive medical imaging from MRIs, invasive biopsies, or cataloging the symptoms. Physicians' primary course of action is to help relieve patient's suffering from chronic gut pain and symptoms through anti-inflammatory drugs.

"There has been increasing evidence that suggests the Crohn's disease immune response may be a result of altered microbes in the gut or exposure to harmful toxins that will result in antibodies against microbial and human proteins being made that are very specific manifestation of the disease," said Ji Qiu. "Many blood-based biomarkers have been discovered, but currently commercially available blood tests have not been widely adapted into clinical practice because they fail to accurately diagnose Crohn's disease."

In the study, which relied on the Biobanks at Mayo Clinic Rochester and Mayo Clinic Arizona, they looked at the serum from 48 patients with Crohn's disease and compared them with the same number of age- and gender-matched healthy controls.


"Biomarker studies can be plagued with issues of sensitivity and specificity," said Qiu. "If we ultimately want to use these are routine tests in the clinic, we have to ensure that that they have the required classification performance in distinguishing patients from healthy controls and other gut disorders."



What does the detection of these autoantibodies mean in our understanding of Crohn's disease?

"One possibility is that these antibodies reflect dysregulated immune response in the gut," said LaBaer. "Another is that they could play a pathogenic role. But so far, we simply don't have enough such antibodies discovered to understand their functional role."


They are buoyed by the initial success of their study, and will conduct future expanded studies on autoantibodies and anti-microbial antibodies against Crohn's disease related microorganisms from microbiome studies.

"Ultimately, we know that no single biomarker is going to be predictive and meet clinical needs," said LaBaer. "Only a panel of biomarkers, made of individually validated biomarkers, will achieve the best performance in the clinic. But we are excited about the potential of this immunoproteomics approach for Crohn's disease and will work to discover additional biomarkers."

