Crohn’s Disease: New Research on Predictive and Environmental Factors

A new method for the early detection of Crohn’s disease a chronic inflammatory disease of the digestive system leads to improved patient management. “Early identification of individuals at high risk of developing the disease can delay, mitigate or even stop the onset of the disease through close monitoring and intervention,” said Jean Frederick Columbia, Professor of Medicine at the Icahn School of Medicine in Mount Sinai and co-director of the study. It was published in the journal Gastroenterology.

Crohn’s Disease

Crohn’s Disease

The prediction of Crohn’s disease five years before the first symptoms

The researchers examined long-term follow-up data from 122 patients with Crohn’s disease. Achieving deep remission at baseline was associated with an 81% reduction in future risk. “The data strongly suggest that achieving deep remission at the onset of Crohn’s disease significantly reduces long-term complications and leads to disease change,” said Ryan Ungaro, lead author of the study. It follows that early treatment of Crohn’s disease can play an important role in slowing the progression of the disease and highlights the link between prognosis and prevention in treating the disease.

In a study of serum biomarkers from military personnel collected and stored by the US Department of Defense, researchers have developed a predictive model for Crohn’s disease. They identified 51 protein biomarkers with 76% accuracy that predict the development of Crohn’s disease in the five years preceding diagnosis. This study suggests that the biological processes were activated many years before the disease, which opens up the possibility of developing targeted strategies to prevent or delay the development of Crohn’s disease. This finding, combined with the fact that early intervention improves outcomes for patients with Crohn’s disease, offers real hope for a disease for which there is no cure.

Connection to the environment

Two other studies suggest that metal exposure in children and genetic factors contribute to the development of Crohn’s disease. In the first study, conducted by Portuguese researchers on baby teeth (in which the history of exposure to metals can be tracked), they found a link between early metal exposure and the risk of future development of Crohn’s disease. The metals identified by the researchers were lead, copper, zinc and chromium. The second study suggests a genetic link in the random transmission of the disease. The researchers examined 38 extended families with at least three first-degree relatives with Crohn’s disease and found that the affected siblings were more likely to be affected one after the other. Elizabeth Spencer, lead researcher in the study, said the grouping of affected siblings suggests that there are other factors besides genetics that contribute to the development of IBD in these families. We will continue to monitor these families to identify any specific causative factors. If we can identify these factors, perhaps we can modify them as a preventive measure for those at high risk of developing Crohn’s disease.

References

https://www.gastrojournal.org/article/S0016-5085(20)30390-5/pdf

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