A new device could help doctors distinguish between two subtypes of inflammatory bowel disease (IBD) and prove a powerful tool in evaluating patients’ response to treatment, according to a recent study.
“Clinical Characterization Of In Vivo Inflammatory Bowel Disease With Raman Spectroscopy” was published in the journal Biomedical Optics Express.
IBD includes ulcerative colitis (UC), which affects the colon, and Crohn’s disease, which can affect any organ in the gastrointestinal tract. The diseases have similar symptoms, including severe diarrhea, pain, fatigue and weight loss. Both manifest through similar symptoms, such as severe diarrhea, pain, fatigue and weight loss, but no single treatment has been proven effective for all patients.
Existing methods for diagnosing and treating UC and Crohn’s disease are inefficient, the researchers said, because they rely on a trial-and-error approach.
“With current methods, ultimately the diagnosis is dependent on how the patient responds to therapy over time, and you often don’t know the diagnosis until it’s been a few years,” Anita Mahadevan-Jansen, senior author of the paper, said in a news release. Furthermore, most tools used during diagnosis and follow-up detect symptoms but are not able to reveal what caused the disease. As a result, many patients receive an incomplete diagnosis or are re-diagnosed based on their response to a therapy.
To resolve that issue, Mahadevan-Jansen and her colleagues built a light-based probe intended to allow doctors to distinguish between the conditions and determine the degree of inflammation in the patient’s intestine. Previous studies of UC or Crohn’s revealed that the diseases are dependent on the activity of different molecules. Based on that knowledge, Mahadevan-Jansen and her colleagues were able to design a probe that could recognize the different molecular signatures of both conditions.
The sensor was designed as a minimally-invasive probe that can be easily integrated into a routine colonoscopy exam, the news release said.
“If someone presents with IBD symptoms … you can use our system again to determine if it’s more likely to be UC or Crohn’s,” Mahadevan-Jansen said. “Then once they are being treated, you have an objective measure to track their response because you can use the device to actually quantify mild, moderate or severe inflammation.”
The device was tested in eight patients with UC, fifteen patients with Crohn’s disease and eight healthy subjects. The probe was able to detect IBD with a high degree of sensitivity, but its ability to distinguish between subtypes varied based on the level of inflammation and the tissue measured.
For example, in measurements performed in the right colon of patients with active inflammation, the sensor was able to help diagnose Crohn’s disease with a sensitivity of 90% and a specificity of 75%.
“These results represent significant progress towards improved real-time classification for accurate and automated in vivo detection and discrimination of IBD during colonoscopy procedures,” the researchers wrote.
In an attempt to improve the specificity of the test, the team now is analyzing data from a larger group of patients to determine which other factors, such as gender, diet, demographics and treatment type, could influence the result. They also are studying other molecular signals the device can track to identify changes induced by treatment, as well as risk factors that may help predict IBD’s onset.
“It’s a unique way of thinking about personalized medicine that takes into account all sorts of information – beyond just the genome – including demographics and many other factors that make a person unique,” Mahadevan-Jansen said. “Our lab has really pushed to find ways to apply optical technology to support this kind of personalized medicine.”
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