Blood Tests May Help Identify IBD in Preclinical Phases

The number of people worldwide affected by inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, has almost doubled in the past three decades. There is no cure for either condition, and early detection is key to improving treatment outcomes, minimizing the need for surgery, and improving quality of life.

A number of patients with IBD already have bowel damage at the time of diagnosis despite having had no gastrointestinal symptoms for more than six months before diagnosis, which accentuates the probability of a pre-clinical phase of the disease. Gaining more understanding of this preclinical phase could open avenues for improving IBD treatment and reducing bowel damage.

Several hematological and biochemical shifts have been associated with IBD and have been used to aid in diagnosis of the disease. These include vitamin and mineral deficiencies, anemia and increased levels of proinflammatory markers, such as C-reactive protein (CRP) and fecal calprotectin. In a study published this month in Cell Reports Medicine, researchers from the Center for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, at Aalborg University in Copenhagen, sought to determine whether these hematological and biochemical changes can be detected during a preclinical phase of IBD.

To do so, lead author Marie Vibeke Vestergaard, Ph.D. student, and her colleagues used data from Danish electronic health records to compare 20,000 people diagnosed with IBD between 2008 and 2018 with controls from 4.6 million people without IBD. The study included 12,466 patients with Crohn’s disease and 23,533 patients with ulcerative colitis,

The research team looked at 10 years of blood test measurements before diagnosis. The tests included measurements for CRP, fecal calprotectin, white blood cells, platelets, hemoglobin, eosinophils, and others. The results showed that levels of neutrophils, leukocytes, and platelets were significantly higher in individuals with Crohn’s compared with controls eight years before diagnosis. For patients with ulcerative colitis, levels of CRP, leukocytes, neutrophils, eosinophils, and platelets were significantly higher compared with controls three years before diagnosis.

The authors conclude that these results suggest IBD begins earlier than previously believed. Vestergaard and her colleagues note that their findings could have implications for future opportunities in developing prevention strategies, including exploring modifiable risk factors, and early treatment options.