Peripheral Blood Exosome Lipid Compositions as IBD Biomarkers

Inflammatory bowel diseases (IBD) that include ulcerative colitis (UC) and Crohn’s Disease (CD) present in varied degrees of severity that are challenging to assess objectively for optimal treatment. Current clinical practices for the assessments clinical IBD disease activity include several noninvasive blood, stool, radiologic and invasive endoscopic tests. However, there is uniform consensus that many of the commonly used noninvasive biomarkers achieve suboptimal sensitivity and specificity for assessing intestinal inflammation. In a recent review of the topic of variables relevant to maintenance of durable clinical remission, Colombel noted that monitoring of patients with “intent to suppress subclinical inflammation has emerged as a treatment goal”. Most importantly, multiple studies show that achievement of “clinical remission” was an inadequate predictor of long-term remission Importantly, in patients with CD 20% of patients in clinical remission still have significant endoscopic disease activity. More importantly, achieving “deep remission” (normalization of clinical, endoscopic and histologic parameters) outperforms other markers as the most reliable predictor of clinical remission. Goal: We seek to develop a novel liquid biopsy method based on circulating exosomes to distinguish moderate to severe from mild and quiescent disease activities in CD and UC compared to C diff-infected and normal controls. We posit that a liquid biopsy approach will contribute considerable clinical value for physicians who seek to accurately assess disease activity and optimize treatment strategies without invasive endoscopic testing.