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Identifying Potential Targets for the Interception of Inflammatory Bowel Disease: Toward Precision Prevention
Sun-Ho Lee1,2, Emily Lopes3,4, Jean-Frederic Colombel5
1Division of Gastroenterology & Hepatology, Termerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Inflammatory Bowel Diseases
|August 20, 2025
Summary
Early changes in the immune system, microbiome, and gut barrier precede inflammatory bowel disease (IBD). Identifying these preclinical signs allows for precision prevention strategies to intercept disease development.
Area of Science:
- Gastroenterology and Immunology
- Microbiome Research
- Disease Prevention
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), has a preclinical phase with detectable immune, microbiome, and barrier changes.
- These early alterations occur years before clinical diagnosis, presenting opportunities for intervention.
Purpose of the Study:
- To review evidence on environmental, microbial, and molecular factors initiating IBD.
- To explore modifiable risk pathways and preventive strategies for IBD.
- To highlight emerging biomarkers for precision prevention.
Main Methods:
- Review of current scientific literature on IBD preclinical phase.
- Analysis of environmental, microbial, and molecular factors.
- Examination of emerging biomarkers and preventive strategies.
Main Results:
- Identified key factors contributing to IBD initiation during the preclinical phase.
- Discussed lifestyle, environmental, and targeted interventions for IBD prevention.
- Highlighted novel biomarkers like anti-flagellin antibodies and glycomic profiles for risk stratification.
Conclusions:
- Early detection of preclinical IBD markers enables targeted prevention.
- Precision prevention strategies tailored to individual risk biology can shift IBD care from treatment to prevention.
- Further research into UC preclinical insights is warranted.
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