Immune changes could signal inflammatory bowel disease up to 10 years before diagnosis
A large-scale study, presented at UEG Week 2026, has identified distinct antibody patterns up to 10 years before the diagnosis of inflammatory bowel disease (IBD), potentially opening new avenues for earlier risk detection and providing insights into future disease course.
A recent study presented at UEG Week 2026 has unveiled distinct antibody patterns that could potentially signal the development of inflammatory bowel disease (IBD) up to 10 years before diagnosis. IBD encompasses chronic conditions like Crohn's disease (CD) and ulcerative colitis (UC), characterized by abnormal immune responses leading to inflammation and damage in the digestive system.
Researchers analyzed 2,000 serum samples from 500 individuals, including 200 with CD, 200 with UC, and 100 healthy controls, collected at various intervals before diagnosis. By profiling antibody responses against numerous antigens, the researchers identified 123,980 unique antibodies, with lower antibody diversity in those who later developed CD or UC.
Specific antibody responses were observed in CD and UC, with elevated responses to herpesviruses and anti-flagellin in CD, and to encapsulated bacteria in UC. Integrating these early antibody signatures using machine-learning models successfully distinguished individuals who would later develop CD or UC from healthy controls up to 10 years before diagnosis, with AUC values of 0.90 and 0.84, respectively.
Complicated CD at diagnosis was associated with a distinct antibody profile years before symptoms, with an AUC of 0.85. Lead author Dr. Arno Bourgonje emphasized the potential of antibody profiling for earlier risk detection, subtype differentiation, and identifying patients who may benefit from early, intensive therapy. However, further research is needed to validate these findings in independent populations and translate them into a clinical screening test.
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