Researchers at the Icahn School of Medicine at Mount Sinai have identified immune system changes that occur up to 10 years before inflammatory bowel disease (IBD) is diagnosed, providing new insight into the earliest stages of disease development.
Published in the journal Gut, the study used antibody profiling technology to analyze nearly 2,000 blood samples collected over approximately a decade from individuals who later developed Crohn’s disease or ulcerative colitis. The researchers identified antibody signatures targeting viral and bacterial antigens that were present years before symptoms appeared.
The findings could support future biomarker development efforts aimed at identifying individuals at increased risk for IBD, although additional research is needed before these signatures can be used clinically.
Mapping immune changes before disease onset
Researchers analyzed antibody responses against 357,000 viral, bacterial, and other antigens using samples collected approximately 10 years, 4 years, and 2 years before diagnosis, as well as after diagnosis. The study included 200 individuals who later developed Crohn’s disease, 200 who developed ulcerative colitis, and 100 healthy controls.
The team found that antibody responses changed over time and differed between individuals who later developed IBD and those who remained healthy. Some of the strongest immune signals were detectable at the earliest time point, nearly a decade before diagnosis.
"IBD does not develop overnight," said Saurabh Mehandru, MD, corresponding author of the study and professor of medicine (gastroenterology) at the Icahn School of Medicine at Mount Sinai, in a press release. "Our findings show that the immune system is already changing years before patients experience their first symptoms. By understanding these early immune changes, we hope to uncover the biological events that trigger disease and ultimately develop strategies to identify, and one day prevent, IBD before it starts."
Among the most notable findings were increased antibody responses against Epstein-Barr virus and bacterial flagellins in individuals who later developed Crohn’s disease. The researchers said these patterns support further investigation into how infections, the gut microbiome, and immune responses may contribute to IBD development.
Toward future biomarker-based risk assessment
"This study allowed us to watch the immune system evolve over an entire decade before disease was diagnosed," said Arno R. Bourgonje, MD, PhD, first author of the study and a postdoctoral fellow in gastroenterology at the Icahn School of Medicine at Mount Sinai, in a press release. "By mapping antibody responses over time, we identified distinct patterns that separate people who later develop IBD from those who remain healthy. These findings provide an important framework for understanding the earliest stages of disease development."
The researchers will continue studying the biology of preclinical IBD to better understand disease initiation and develop approaches for earlier identification and prevention. The findings may eventually help guide testing strategies for individuals at higher risk, including relatives of patients with IBD.
Note: This news summary was generated by AI based on a published press release, followed by a review from human editors.
