Indian-American scientist finds simple way to predict IBD

An Indian-American scientist has identified as many as 50 protein biomarkers that can non-invasively detect inflammatory bowel disease (IBD) - a gut disorder that leads to diarrhoea, abdominal cramps, and weight loss.

Chander Mohan, a professor at University of Houston in the US, received a USD 347,490 grant from the Crohn's & Colitis Foundation of America.

Along with IBD expert Subra Kugathasan, a gastroenterologist at Emory University in the US, Mohan is examining stool protein biomarkers that indicate the disease.

IBD occurs when the body's immune system fights its intestinal cells. Two of the most common types are Crohn's disease and ulcerative colitis, both of which cause inflammation in the digestive tract.

It leads to a variety of recurring symptoms such as diarrhea, abdominal cramps, blood in stools and weight loss.

"The disease is diagnosed by inserting an endoscope into the digestive tract to obtain a biopsy. However, this procedure does not lend itself to frequent disease monitoring or home-care tests," Mohan told PTI.

"To circumvent this, we asked if the stools from these patients might harbour specific molecules that we could potentially track," he said.

"To our pleasant surprise, an initial screen of patient stools revealed multiple proteins that are significantly elevated only in diseased patients," Mohan said.

"Confirming these findings in larger cohorts of patients may lead to novel stool tests for diagnosing and monitoring inflammatory bowel disease," he said.

"Prompt diagnosis and tracking of disease activity would help clinicians tailor the medications accordingly so that the disease is well under control," Mohan said.

With the right biomarkers, we could be in the position to predict the diseases even before a diagnosis is made using conventional approaches, researchers said.

For two decades only one stool protein, faecal calprotectin, has been used to predict IBD, but it is suboptimal, according to Mohan, because its specificity and sensitivity is not perfect in predicting the diseases.

Until now, no one looked for other stool proteins in a comprehensive fashion.

By examining the levels of 1,100 different proteins in IBD stool samples researchers have narrowed down to 50, the number of proteins that are consistently elevated in IBD stools.

Better disease diagnosis, monitoring and therapy in IBD can significantly improve the lives of patients. Diagnosing or monitoring the disease from a stool test is easier and less invasive and inexpensive compared to endoscopy or colonoscopy.

For instance, a patient already diagnosed with IBD might find out early if the disease is flaring or the symptoms are merely transient, indicating a momentary disturbance.

The hope is that the biomarker will tell the difference. If the disease is flaring up, the biomarker in the stool will increase, meaning the patient can get treated quicker.

Mohan envisions a self-care or easy-care kit one day where patients can immediately understand what is happening inside, much like the saliva test and home-test kit for lupus his team is creating.

"If we have the right biomarkers, this has the potential to be a major breakthrough," said Mohan.