IBD, which is characterized by chronic inflammation in all or part of the digestive tract, affects millions of people worldwide. Its principal forms are Crohn's disease, which can occur at any point of the gastrointestinal tract, and ulcerative colitis, which affects only the colon and rectum.
"Identifying these patients early could eventually allow clinicians to move more quickly toward therapies that address the specific mechanism of disease rather than relying on a trial-and-error sequence of medications," Dr. Brad Pasternak, medical director of the IBD Clinic at Phoenix Children's Hospital, who was not involved in the work, told Live Science in an email.
A potential subtype of IBD
The new study, published June 10 in The New England Journal of Medicine, helps connect the dots.
IL-10 normally works by inhibiting the secretion of pro-inflammatory proteins, so patients whose bodies block IL-10 are effectively releasing a brake that should be holding off inflammation, Pasternak said.
The study included data from over 4,900 people with IBD and over 1,000 without the condition. Using two separate lab tests, the researchers analyzed blood samples from both groups, finding the autoantibody in 173 of the IBD patients, or about 3.5%. The autoantibody was virtually absent from the blood of the comparison group.
Study co-author Dr. Holm Uhlig, a pediatric gastroenterologist at the University of Oxford, told Live Science that identifying what drives the formation of the autoantibodies will be "a question of intense interest." For now, though, their data suggests that patients carrying HLA-DRB1*01:03 are far more likely to have autoantibodies blocking IL-10 than those without the variant.
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In general, many IBD patients are currently treated with therapies that broadly suppress inflammatory pathways, Pasternak said, but not everyone responds to treatment. This study points to a potential way to someday tailor treatments to the mechanism driving specific patients' diseases, he said.
"Patients could undergo genetic testing already in the early stage of their disease diagnosis," he said, "and then it would determine their susceptibility to develop autoantibodies."
This article is for informational purposes only and is not meant to offer medical advice.
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