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Gastrointestinal endoscopy biopsy derived proteomic patterns predict indeterminate colitis into ulcerative colitis
Billy Ray Ballard1, Amosy Ephreim M'Koma1
1Billy Ray Ballard, Department of Pathology, Meharry Medical College School of Medicine, Nashville, TN 37208-3599, United States.
Insights
Diagnosing indeterminate colitis (IC) is challenging, often requiring advanced proteomic analysis of endoscopic biopsies. This new method aims for a single, accurate test to differentiate ulcerative colitis (UC) or Crohn
Area of Science:
- Gastroenterology and Inflammatory Bowel Disease (IBD) research.
- Proteomics and Biomarker Discovery.
- Diagnostic Innovation in Colitis.
Background:
- Indeterminate colitis (IC) presents significant diagnostic challenges, particularly in pediatric patients, with current classification systems failing to definitively diagnose ulcerative colitis (UC) or Crohn's colitis (CC) in 15-30% of inflammatory bowel disease (IBD) cases.
- The inability to accurately differentiate IC into UC or CC leads to suboptimal patient outcomes, especially following restorative proctocolectomy and ileal pouch-anal anastomosis.
- Diagnostic accuracy for IC has remained stagnant for decades despite advancements in clinical, endoscopic, radiologic, and histologic examinations.
Purpose of the Study:
- To develop a single, highly sensitive, and accurate diagnostic test for indeterminate colitis (IC) during the initial patient visit.
- To utilize endoscopic biopsy-derived proteomic patterns for precise differentiation of IC into ulcerative colitis (UC), Crohn's colitis (CC), or non-IBD conditions.
- To provide a novel diagnostic tool that assists clinicians in the early and accurate management of IBD patients with IC.
Main Methods:
- Employing Matrix-assisted-laser desorption/ionization mass spectrometry (MS) and/or imaging MS technologies.
- Performing a histology-directed cellular test on endoscopic biopsy samples.
- Identifying phenotype-specific proteins as biomarkers for accurate IC subtyping.
Main Results:
- The proteomic approach using MS technologies has the potential to identify phenotype-specific proteins.
- These identified proteins serve as biomarkers to accurately delineate IC as UC, CC, or a non-IBD condition.
- Ongoing studies on larger cohorts are expected to validate the high accuracy and sensitivity of this novel diagnostic method.
Conclusions:
- A novel diagnostic approach using proteomic patterns from endoscopic biopsies shows promise for accurately differentiating UC from CC in IC patients.
- This innovative method could significantly improve patient management and outcomes by enabling precise diagnosis during the first clinical encounter.
- Further research on larger cohorts is crucial to validate these findings and explore potential mechanistic insights into IBD pathogenesis.
Abstract:
Patients with indeterminate colitis (IC) are significantly younger at diagnosis with onset of symptoms before the age of 18 years with significant morbidity in the interim. The successful care of IC is based on microscopic visual predict precision of eventual ulcerative colitis (UC) or Crohn's colitis (CC) which is not offered in 15%-30% of inflammatory bowel disease (IBD) patients even after a combined state-of-the-art classification system of clinical, visual endoscopic, radiologic and histologic examination. These figures have not changed over the past 3 decades despite the introduction of newer diagnostic modalities. The patient outcomes after restorative proctocolectomy and ileal pouch-anal anastomosis may be painstaking if IC turns into CC. Our approach is aiming at developing a single sensitive and absolute accurate diagnostic test tool during the first clinic visit through endoscopic biopsy derived proteomic patterns. Matrix-assisted-laser desorption/ionization mass spectrometry (MS) and/or imaging MS technologies permit a histology-directed cellular test of endoscopy biopsy which identifies phenotype specific proteins, as biomarker that would assist clinicians more accurately delineate IC as being either a UC or CC or a non-IBD condition. These novel studies are underway on larger cohorts and are highly innovative with significances in differentiating a UC from CC in patients with IC and could lend mechanistic insights into IBD pathogenesis.
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