Crohn's Disease: Better Prediction = Better Treatment

Researchers from the University of North Carolina School of Medicine and corresponding colleagues report that they have identified a set of biomolecules called microRNAs, and specifically microRNA-31 (miR-31), that can aid in predicting disease severity in patients with Crohn’s disease. This capability, according to the authors, may facilitate better tailoring of treatment to specific patient presentations. Co-senior author Shehzad Sheikh, MD, PhD, associate professor of medicine and genetics, commented, “For such a clinically heterogenous disease, this kind of molecular phenotyping is a major step towards personalization of medical therapy. These results add to a series of papers from our group where we combine genomic technologies with rigorous validation in patient-derived, disease-relevant cell systems to develop molecular markers with prognostic utility.” The findings were published in the Journal of Clinical Investigation (JCI) Insight.

The worldwide incidence of Crohn’s disease has been on the increase for the past 50 years, and currently used medications are accompanied by risk for side effects that include opportunistic infection and cancer. The course of the illness also varies widely between patients, making prediction of severity useful in the design of treatment response. The UNC study performed small-RNA sequencing on colon tissue from 18 adults with Crohn’s along with 12 control subjects, and 76 pediatric Crohn’s patients plus 51 controls. Low colonic expression of miR-31 in adult patients who were indicated for surgery was associated with worse disease outcomes and higher incidence of recurrence. In children, low expression of miR-31 at the time of diagnosis was linked to likelihood for development of intestinal strictures that necessitated surgery. Noting prior advances in classifying cancer subtypes through molecular signatures, co-senior author Terry Furey, PhD, commented, “Our long-term goal, extending the work in this study, is to uncover molecular subtypes of Crohn’s disease to not only increase our understanding of the root causes of the disease and the vast clinical heterogeneity, but also to more strategically use current therapies and provide the basis for new therapies that specifically target these subtypes.”

Read the study findings.

The journal article may be read here.