Methods for diagnosing and treating inflammatory bowel disease
Methods and materials are disclosed for testing biomarkers in a subject suffering from inflammatory bowel disease (IBD) are described herein. Such detection can be useful for diagnosing and treating ulcerative colitis (UC) and Crohn's disease (CD), two forms of IBD that are otherwise difficult to distinguish. The method includes measuring the level of one or more of several biomarkers, including HD5 or MMP-7, which are expressed differentially in patents with UC and CD. A treatment may be based on the determination of whether the subject has ulcerative colitis or Crohn's disease.
1. A method of diagnosing and treating at least one of ulcerative colitis, severe ulcerative colitis, or Crohn's disease in a patient suffering from or at risk of inflammatory bowel disease (IBD), said method comprising:
obtaining a sample from the patient;
measuring at least one of the expression of MMP-7 and the concentration of MMP-7 in the sample;
comparing the expression of MMP-7 or the concentration of MMP-7 in the sample to a benchmark value that is typical of a subject afflicted with Crohn's disease and not suffering from ulcerative colitis or severe ulcerative colitis; and
either
diagnosing Crohn's disease if the expression of MMP-7 or the concentration of MMP-7 in the sample does not significantly exceed the benchmark value and performing a non-surgical intervention on the patient to treat the Crohn's disease, wherein the non-surgical intervention comprises administration of a drug; or
diagnosing ulcerative colitis or severe ulcerative colitis if the expression of MMP-7 or the concentration of MMP-7 in the sample significantly exceeds the benchmark value and performing a surgical intervention on the patient to treat the ulcerative colitis or severe ulcerative colitis.
2. The method of claim 1 , further comprising diagnosing Crohn's disease if the expression of MMP-7 is measured to be significantly less in the sample than in a control sample from a subject suffering from ulcerative colitis or severe ulcerative colitis.
3. The method of claim 1 , wherein the sample is intestinal tissue, and comprising measuring the concentration of MMP-7 by: immunostaining the sample with an antiMMP-7 immunostaining agent; and measuring the percentage of cells in the sample that stain positive.
4. The method of claim 1 , wherein the non-surgical intervention is not effective to treat ulcerative colitis or severe ulcerative colitis.
5. The method of claim 1 , wherein the non-surgical intervention is administration of a drug selected from the group consisting of: a vitamin supplement, vitamin B12, vitamin D, a mineral supplement, calcium, an anti-inflammatory, a corticosteroid, a 5-aminosalicylate, an immunosuppressant, azathioprine, mercaptopurine, an anti-TNF-alpha antibody, infliximab, adalimumab, certolizumab pegol, methotrexate, an anti-a4-integrin antibody, natalizumab, vedolizumab, an anti-interleukin antibody, ustekinumab, an antibacterial antibiotic, ciprofloxacin, and metronidazole.
6. The method of claim 5 , wherein the non-surgical intervention is administration of a drug selected from the group consisting of: vitamin B12, vitamin D, calcium, certolizumab pegol, methotrexate, and natalizumab.
7. The method of claim 1 , wherein the non-surgical intervention further comprises placement of the patient on a low fat diet.
8. The method of claim 1 , wherein the surgical intervention is not effective to treat Crohn's disease.
9. The method of claim 1 , wherein the surgical intervention is a surgery selected from the group consisting of: aproctocolectomy, and an ileal pouch anal anastomosis.