In the treatment of many diseases specific tests are used to identify patients who are going to have a worse disease course and therefore need additional treatments. The authors of this study found that particular white blood (immune) cells had an increased expression of their genetic code in patients who had a worse disease course in inflammatory diseases other than IBD. In IBD such a test is not yet available but this article suggests a possible area for the development of one. Such a test may help to identify which patients need early treatment with stronger drugs such as infliximab or conversely which patients will do well on mild treatments.
In this study specific white blood cells (CD8 T cells) were taken from the blood and the expression of genetic code was measured. Two very different patterns were found and labelled “IBD1” and “IBD2”. In both Crohn’s and UC the patterns were the same and interestingly they were also the same as in patients with other inflammatory diseases. 35 adults with Crohn’s disease and 32 with Ulcerative Colitis were recruited during active disease and studied for two years. In both Crohn’s and UC, patients with the IBD1 pattern were more likely to have persistent disease and require more intensive drug treatment than those with IBD 2.
These IBD patterns were better at showing the patients with the worst disease course than clinical signs used in routine current practice. This test is clearly at a very early stage but is an exciting prospect for the future.
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