EU - Inflammatory bowel disease diagnosis method

An early and accurate detection of chronic diseases is crucial in view of a proper intervention. It can also contribute in facilitating the monitoring of disease progression and therapeutic response. In particular, the diagnosis of inflammatory bowel disease (IBD) in childhood, can be challenging. The diagnosis is based on detection of chronic inflammation in the gastrointestinal (GI) tract and exclusion of other causes of inflammation. The differentiation of Crohn’s disease (CD) from ulcerative colitis (UC), and both of these from infectious diseases, allergic diseases, or primary immunodeficiency disorders (PIDs) with similar presentations is based on a combination of clinical suspicion, endoscopic and histological evaluation of the mucosa, and other additional tests in case of uncertainty. An international group of European experts in pediatric inflammatory bowel disease (PIBD).The ‘‘Porto’’ IBD Working Group of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) stated that an “accurate diagnosis of inflammatory bowel disease should be based on a combination of history, physical and laboratory examination, esophagogastroduodenoscopy (EGD) and ileocolonoscopy with histology, and imaging of the small bowel. The concentration of calprotectin in feces has been shown to correlate well with the disease activity in IBD and to help differentiate IBD from other functional intestinal disorders, such as irritable bowel syndrome. Over the last decade Raman spectroscopy has proved to be a versatile tool in clinical diagnostic. This is because any altered biochemistry in the body that is specific to a particular disease and that will precede macroscopic tissue changes will be reflected in a Raman spectrum. We propose here a spectroscopic method to diagnose and differentiate inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn’s disease (CD) with pediatric onset, in a complete noninvasive way without performing any intestinal biopsy. In particular, the Raman technique was applied to proteic extract from fecal samples to achieve information about molecular vibrations that can potentially furnish spectral signatures of cellular modifications occurring as a consequence of specific pathologic conditions. The attention was focused on the investigation of the amide I region. We have conducted a preliminary study on a small patients’ cohort. Inflammation is found to give rise to a significant increasing of the nonreducible (trivalent)/reducible (divalent) cross-linking ratio R of the protein network. This parameter revealed an excellent marker to distinguish IBD subjects from non-IBD ones, and, among IBD patients, to differentiate between UC and CD. The proposed methodology was validated by statistical analysis using the receiver operating characteristic (ROC) curve.