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Crohn’s disease — a type of inflammatory bowel disease (IBD) — causes symptoms including abdominal pain, diarrhea and weight loss. Treatment aims to reduce inflammation, improve symptoms and promote digestive tract healing, but assessing disease activity in the intestines requires invasive endoscopy and colonoscopy procedures.
Lori Coburn, MD, associate professor of Medicine, and colleagues in the Division of Gastroenterology, Hepatology and Nutrition at Vanderbilt Health are seeking to identify noninvasive blood markers of Crohn’s disease activity.
They previously demonstrated increased serum cytokines — immune cell signaling molecules — that correlated with clinical disease activity in patients with Crohn’s disease versus individuals without IBD. In a recent study published in Scientific Reports, they extended their earlier research to identify cytokines that differ between patients with Crohn’s disease and non-IBD controls, and that differ by clinical, endoscopic and histologic disease activity.
The researchers measured multiple cytokines in blood serum samples from 103 patients with Crohn’s disease and 40 non-IBD controls undergoing colonoscopy. They determined disease activity clinically using the Crohn’s Disease Activity Index; endoscopically using the Simple Endoscopic Score for Crohn’s Disease; and histologically from colonoscopic biopsies.
They found that multiple cytokines were significantly altered between patients with active and inactive Crohn’s disease versus non-IBD controls. One cytokine, CXCL9, was increased in active versus inactive Crohn’s disease in both endoscopic and histologic activity assessments.
CXCL9 had the highest capacity to discriminate between active and inactive Crohn’s disease both endoscopically and histologically, suggesting it could serve as a potential noninvasive marker to assess disease activity, the researchers noted.
Gabriella Raffa, MD, MSCI, first author of the Scientific Reports study, completed a gastroenterology fellowship and Master of Science in Clinical Investigation training at Vanderbilt Health and is now assistant professor of Clinical Medicine at the University of Miami Miller School of Medicine. Coburn is the paper’s senior and corresponding author. Co-authors, all from Vanderbilt Health, are Regina Tyree, MS, Kate Carson, MPH, Margaret Allaman, Dawn Beaulieu, MD, Robin Dalal, MD, Baldeep Pabla, MD, MSCI, Elizabeth Scoville, MD, MSCI, Sara Horst, MD, MPH, David Schwartz, MD, Mary Kay Washington, MD, PhD, and Keith Wilson, MD.
The research was supported by the Leona M. and Harry B. Helmsley Charitable Trust; Department of Veterans Affairs; National Institutes of Health (grants T32DK007673, R01DK128200, P30DK058404, P30CA068485 and P01CA116087); Thomas F. Frist Sr. Endowment; Vanderbilt Center for Mucosal Inflammation and Cancer; Crohn’s & Colitis Foundation; Department of Defense; CURE for IBD; and James Rowen Fund.
