Compositions and methods to detect gastrointestinal disease
This invention comprises compositions and methods to determine the prognosis of necrotizing enterocolitis.
1. A method for determining the prognosis of necrotizing enterocolitis (NEC) in an infant, the method comprising:
a) fitting a Markov model using a two state transition matrix and propensity values determined for a plurality of subjects, wherein the two state transition matrix comprises a first state and a second state, wherein the first state comprises a non-necrotizing enterocolitis status, wherein the second state comprises a necrotizing enterocolitis status, wherein a propensity value is a function of intestinal Alkaline Phosphatase (iAP) activity values and the amount of iAP found in a stool sample;
b) using a propensity value of the infant and the fitted Markov model to estimate a probability of transitioning from the first state to the second state, wherein the fitted model indicates that an increased propensity level of the infant significantly increases the probability of transitioning from the first state to the second state;
c) Identifying a propensity value of the infant that is greater than or equal to a threshold value of about 0.5, and treating the infant wherein the treating comprises withholding oral feeding, administering an antibiotic, a probiotic, an intravenous fluid, an iAP replacement composition, a small molecule effector of catalytic activity, an anti-inflammatory agent, parenteral or intravenous nutrition, a biologic, or a combination thereof.
2. The method of claim 1 , wherein a propensity value comprises a product of a first value and a second value, wherein the first value comprises one (1) minus a first ratio, wherein the first ratio comprise an iAP activity value of a subject of the plurality of subjects divided by a maximum iAP activity value observed among the plurality of subjects, wherein the second value comprises a second ratio, wherein the second ratio comprises an amount of iAP from an immunoassay value of a subject of the plurality of subjects divided by a maximum amount of iAP from an immunoassay value observed in a sample.
3. The method of claim 1 , wherein a propensity value comprises a product of a first value and a second value, wherein the first value comprises one (1) minus an iAP activity value of a subject of the plurality of subjects, wherein the second value comprises an amount of iAP from an immunoassay value of a subject of the plurality of subjects.
4. The method of claim 2 or 3 , wherein the immunoassay comprises a western blot, an ELISA, or immunoprecipitation.