The problem with IBD treatment

Crohn's disease and ulcerative colitis are treated only after symptoms appear, when the gut has already been damaged. At least three point eight million people worldwide live with IBD.

Warning signs appear years early

Scientists found the immune system sends warning signals up to a decade before diagnosis. Dr Arno Bourgonje at the University Medical Centre Groningen and Mount Sinai said the disease begins years before symptoms appear.

“The disease begins years before symptoms appear, and the immune system leaves warning signs long before diagnosis.”

How the research worked

Bourgonje and colleagues at Mount Sinai and the Medical University of Vienna tested blood samples from US military personnel.

Crohn's disease antibody pattern

In people who went on to develop Crohn's disease, antibodies against Epstein-Barr virus, which causes glandular fever, were more common. The differences were already visible a decade before diagnosis.

Ulcerative colitis shows different pattern

People who developed ulcerative colitis showed a different antibody pattern, including antibodies against one of the body's own proteins. The findings were published in the journal Gut.

Expert caution on clinical use

James Lindsay, a professor of gastroenterology at Barts Health, said the study provided important insights but cautioned the techniques were very much a research tool and not yet ready for the clinic.

“Very much a research tool and not yet ready for the clinic.”

Path forward for prevention

The hope is that IBD could eventually follow type one diabetes, where a blood test identifies people whose immune systems have begun attacking the pancreas before symptoms appear, allowing treatment that delays disease onset.