People with debilitating Crohn’s disease have been offered new hope of better treatment.
Doctors in New York have worked out how to tell if a Crohn’s drug will work or not after analysing patients’ bowel tissue.
The illness, a serious form of inflammatory bowel disease (IBD), is a lifelong condition which causes diarrhoea, stomach aches and cramps, blood in stools, tiredness, and weight loss. It affects thousands of people in Britain.
Medical researchers are now planning to find a blood test to tell them what treatment to prescribe – but it still needs to be trialled.
Their study, published in the journal Cell, involved mapping more than 100,000 immune cells to find specific cell types which can tell doctors if the standard therapy, using an anti-imflammatory, will work or not.
Researchers at Mount Sinai Hospital in New York looked examined immune and blood cells around intestinal lesions, caused by the disease, and found a “signature” pattern.
Doctors noticed that patients with that pattern could be successfully treated with the anti-inflammatory drug called a TNF inhibitor by comparing it with others who had already been treated.
At the moment, 40 per cent of patients don’t respond to the medicine – or it makes them worse.
One of the study authors, Dr. Miriam Merad, said: “Single-cell profiling could transform drug discovery.
“It’s really going to give us much more clarity into inflammatory bowel disease and why patients are resisting and what else we could be targeting.”
Being able to identify patients who will fail on the drug could help them avoid surgery and complications.
Based on this study’s results, researchers have already developed a clinical trial to test whether it’s possible to find the cell signature in a blood test when a patient is diagnosed with inflammatory bowel disease.
If it works, doctors could avoid using a TNF inhibitor and instead use other medicines that will work for that patient.
Another co-author, Dr. Judy Cho said: “We designed this study in a way that defines inflammation with unprecedented precision using immunology and computational biology to get a better understanding of this disease.
“These results emphasize the limitations of current diagnostic assays and the potential for single-cell mapping tools to identify novel biomarkers for treatment response and tailored therapeutic opportunities.”
Co-author Dr Ephraim Kenigsberg aded: “Our study shows that approaches that combine high-resolution single-cell mapping of inflammatory lesions in small numbers of patients with bulk RNA sequencing on large cohorts with extensive clinical characterisation leads to generalisable insights, highlighting the potential to broadly transform understanding of human multi-factorial immune-mediated inflammatory diseases.
