Developing a blood test to monitor gut healing in Ulcerative Colitis

What is this research looking at? 

We have more treatments for Crohn’s and Colitis than ever before. And more new treatments are being developed. But, at the moment we cannot predict which treatment will work best for which person. So, doctors and nurses often use a ‘one size fits all’ approach to deciding which treatments to use and in what order. But almost half of all people given a particular medicine will not respond well to it. Some people need to try several medicines before they find one that works well for them. This can mean that people with Crohn’s and Colitis:

• Have longer flare-ups that are harder to treat.
• Have increased risk of disease complications.
• Are more likely to experience side effects from their medicines.

The main aim of medical treatment for Crohn’s and Colitis is complete healing of the gut. But, it is difficult to track gut healing and response to treatment quickly and accurately. Current tests to monitor inflammation of the gut include endoscopy and faecal calprotectin. Endoscopy is an intrusive test and not liked by many people with Crohn’s or Colitis. The faecal calprotectin (poo test) can be difficult to perform and there is often a delay in reporting the results of the faecal calprotectin test. This means that it can be difficult to work out quickly how well the gut is healing in response to a certain medicine.

Previous research has shown that more than two out of three people would prefer to have a blood test than a poo test. The aim of this research is to develop a blood test that can monitor gut healing in response to treatment.

First the researchers will measure the levels of different proteins in the blood of people who have recently been diagnosed with Ulcerative Colitis. They will do this using a new technique called proximity extension assay (PEA). PEA can measure lots of different proteins in one blood test. The researchers will compare the levels of proteins found in the blood samples with the results from endoscopy and faecal calprotectin tests. They will continue to track gut inflammation in this way over 12 months. By doing this they hope to find a mix of proteins that accurately shows the level of gut healing.

The researchers will use this mix of proteins to develop a blood test. They will then will check this blood test in a larger number of people with Crohn’s or Colitis. This is to check whether this is a consistent and accurate measure of gut healing.

What do researchers think this could mean for people with Crohn's and Colitis?  

The researchers hope to develop a blood test that can quickly and accurately show the level of gut healing. It is hoped that this will be a more acceptable test for people living with Crohn’s and Colitis. The results from this blood test will be available more quickly than the results from other tests that are used at the moment. This will allow us to better monitor an individual’s response to a certain treatment. This means that treatment can be tailored to the individual at an early stage. This will help to achieve early gut healing and prevent long-term complications.

Who is leading this research: Dr Rahul Kalla, University of Edinburgh

Our Funding: £92,409

Duration: 24 months 

Official title of application: Translating a novel blood multi-protein biomarker using PEA-technology for prospective mucosal healing in UC.