Genetic Test to Predict Inflammatory Bowel Disease Risk in Children

New genetic test helps in early diagnosis of inflammatory bowel disease in children and also predict its severity.

Highlights:

New genetic test, GA-map IBD Dysbiosis Test, analyzes the fecal samples and uses DNA profiling to identify over 300 species of intestinal microbiota.
This test will help identify children who are at a risk of developing aggressive inflammatory bowel disease (IBD) later in life, and who need early intervention.
The test helped to show that the abundance of different bacterial species was significantly reduced in the children with IBD, compared to the healthy children.

New genetic test that helps to characterize intestinal microbiota may help diagnose inflammatory bowel disease (IBD) in children.

The Norwegian study could be a step forward in predicting which children would develop the disease extensively and would therefore need early and aggressive intervention.

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Inflammatory bowel disease involves chronic inflammation of the colon and small intestine. Symptoms include diarrhea, abdominal pain and weight loss.

‘Genetic test that assesses the fecal microbiota profiles may help identify children prone to severe form of inflammatory bowel disease.’

Dr Christine Olbjørn, from the Department of Paediatric and Adolescent Medicine at Akershus University Hospital in Oslo said, that this type of microbiota profiling could be useful in pediatric practice and long-term patient care.

The research team evaluated the fecal microbiota profiles of children diagnosed with IBD and also children who were healthy. The profiling showed a clear distinction between the two groups.

It was found that a most disturbed microbiota profiling called dysbiosis caused the development of extensive IBD. These children would need biological therapy in the future.

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"IBD is often far more aggressive in children than it is in adults but it is very difficult to predict the individual disease course" said Dr Christine Olbjørn, lead researcher. "We and other researchers are interested in the potential of faecal microbiota profiling to help us diagnose and manage these children and we have been helped by the availability of new genetic tests that can quantify different bacterial species in the gut."

Inflammatory Bowel Disease (IBD)

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Canada has amongst the highest rates of pediatric inflammatory bowel disease (IBD) in the world.

Inflammatory bowel disease is a chronic inflammatory condition of the digestive tract. It is a debilitating disorder that could lead to life-threatening complications.

Though the exact cause of IBD is unknown, genetics, family history, immune system malfunction, childhood infection, and environmental factors are known to trigger its onset.

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The gut microbiome of people with inflammatory bowel disease differs from that of healthy patients and is associated with symptoms of the disease.

The two main types of IBD are ulcerative colitis and Crohn's disease.

Ulcerative colitis affects the colon and rectum and it is characterized by long-lasting inflammation and ulcers in the innermost lining of the intestine.

Crohn's disease can affect any part of the digestive tract including small intestine or large intestine or both. It can affect all layers of the intestine.

The symptoms usually include

Pain
Diarrhea
Fatigue
Weight Loss
Loss Of Appetite

Across Europe, the number of cases of IBD are on the rise.

In Europe, around 500,000 are affected by ulcerative colitis and 30,000 new cases are diagnosed each year.

Crohn's disease affects about 250,000 people, with around 18,000 new cases per year.

A third of the total number of IBD cases can be attributed to childhood onset of IBD. In children, IBD can affect the psychological, emotional and mental health. It also negatively affects their education level.

Study

For the study, fecal samples from 235 children and adolescents (80 children with Crohn's disease, 27 with ulcerative colitis, three with unclassified IBD, 50 with symptoms, but no IBD diagnosis, and 75 healthy children), were collected.

The new test, called the GA-ma IBD Dysbiosis Test, was used to analyze the fecal samples. The test helps to identify up to 300 different bacteria on different taxonomic levels by using advanced DNA profiling.

A comparison of the microbiota profiles was then made between the children with IBD, those with symptoms but no IBD diagnosis, and healthy children.

It was found that the probe signal intensity, that is meant to indicate the abundance of different bacterial species, was significantly reduced in children diagnosed with IBD and those who had symptoms, but had not been diagnosed, compared to the children who had no significant health issues .

"What was perhaps more intriguing was that the children with more extensive IBD had significantly more Clostridiales, and those with extensive Crohn's disease had more Proteobacteria than children with limited disease. Children who were subsequently treated with TNF blockers had a lower diversity of Firmicutes, Tenericutes and Bacteroidetes as well as lower abundance of Actinobacteria before treatment than those who were ultimately treated with conventional medications." said Dr Olbjørn.

The dysbiosis of gut microbia also played a key role in the pathogenesis of IBD in children.

"Our findings suggest that fecal microbiota profiles may be used to identify which children are destined for a more severe form of IBD and which, therefore, need more intensive monitoring and possibly earlier, more aggressive treatment." added Dr Olbjørn.

The findings were presented at the annual meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) in Prague.

References

Inflammatory bowel disease (IBD) - (http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/definition/con-20034908)