A study led by Dr. Arno Bourgonje at UEG Week 2026 revealed that distinct antibody patterns emerge up to 10 years before an inflammatory bowel disease diagnosis. Analyzing 2,000 serum samples from 500 military personnel, machine-learning models discriminated future Crohn's disease and ulcerative colitis patients with AUC values of 0.90 and 0.84. Experts note the research tool requires prospective validation across diverse populations before clinical screening can begin.
Machine-learning models for early disease prediction
- ▪Machine-learning antibody profiles differentiated individuals who later developed complicated Crohn's disease from non-complicated Crohn's disease up to approximately 10 years before diagnosis with an AUC value of 0.85.
- ▪Machine-learning models integrating early antibody signatures discriminated individuals who would later develop Crohn's disease or ulcerative colitis from healthy controls up to 10 years before diagnosis, with AUC values of 0.90 and 0.84, respectively.
Study cohort and overall antibody profiling
- ▪Researchers profiled antibody responses against approximately 357,000 antigens across 2,000 serum samples, identifying 123,980 unique antibodies and finding significantly lower antibody diversity in individuals who later developed Crohn's disease or ulcerative colitis.
- ▪A study led by Dr. Arno Bourgonje analyzed 2,000 serum samples from 500 US military personnel—including 200 who developed Crohn's disease, 200 who developed ulcerative colitis, and 100 healthy controls—collected up to 10 years before diagnosis.
Antibody patterns preceding Crohn's disease
- ▪In individuals who later developed Crohn's disease, elevated antibody responses against herpesviruses, including Epstein-Barr virus, and anti-flagellin antibodies were observed up to 10 years before clinical diagnosis.
- ▪Antibody responses to encapsulated bacteria progressively declined towards diagnosis in individuals who later developed Crohn's disease, with elevated herpesvirus and flagellin signatures particularly pronounced in severe, complicated disease.
Expert perspectives on study implications
- ▪Dr. Arno Bourgonje stated that distinct antibody profiles years before symptoms indicate that complicated Crohn's disease begins long before diagnosis, creating opportunities for earlier risk detection and targeted therapy.
- ▪Marianne Radcliffe, chief executive of Crohn's & Colitis UK, stated that insights into pre-symptomatic immune changes represent an important step forward in understanding how Crohn's and colitis develop over time.
Validation needed before clinical application
- ▪Dr. Arno Bourgonje stated that early antibody signatures must be validated in independent, more prospective populations and evaluated alongside genetic and clinical markers before translation into an affordable targeted clinical screening test.
- ▪Barts Health gastroenterology professor James Lindsay cautioned that the study's antibody profiling techniques currently represent a research tool rather than a clinical tool ready for medical practice.
Living with inflammatory bowel disease
- ▪Inflammatory bowel disease treatments rely on anti-inflammatory and immune-suppressing drugs, though many patients fail to respond to these medications.
- ▪At least 3.8 million people worldwide live with inflammatory bowel disease, an immune condition driving chronic digestive tract inflammation that can lead to surgery or increased bowel cancer risk.
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