Phenotype Appears to Predict Complicated Crohn Disease

A specific preclinical serological signature is strongly associated with complicated Crohn’s disease at diagnosis, according to study findings published online ahead of print in Clinical Gastroenterology and Hepatology.

“At diagnosis, up to one-third of patients with Crohn’s disease have a complicated phenotype with stricturing (B2) or penetrating (B3) behavior or require early surgery,” explained corresponding author Joseph A. Murray, MD, of the Mayo Clinic Division of Gastroenterology and Hepatology in Rochester, Minnesota, and coauthors in the study background.

The study included an analysis of protein biomarkers and antimicrobial antibodies in 201 patients with Crohn’s disease archived years before diagnosis. Among them, 24% had B2 phenotype, B3 phenotype, or required surgery at diagnosis.

Six years before diagnosis, patients with complications had higher levels of antimicrobial antibodies than patients without complications at diagnosis, according to the study. Additionally, nearly 2 dozen protein biomarkers were associated with complicated Crohn’s disease.

The specific preclinical serological signature of complicated Crohn’s disease included biomarkers of innate and adaptive immunity, fibrosis, tissue damage, and a heightened antibody response to commensal microorganisms, the study showed.

“The findings of the current study suggest that specific preclinical signatures predict the development of Crohn’s disease-related complications years before diagnosis,” researchers wrote, “which could result in improved prevention strategies and uncover pathways important in disease progression.”

—Jolynn Tumolo

Reference:
Choung RS, Petralia F, Torres J, et al. Preclinical serological signatures are associated with complicated Crohn’s disease phenotype at diagnosis. Clin Gastroenterol Hepatol. Published online February 12, 2023. doi:10.1016/j.cgh.2023.01.033