Last May, scientists at McMaster University reported their discovery of new biomarkers that could be used to detect the presence of Irritable Bowel Syndrome (IBS) through analyzing urine.
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Published in the journal Metabolomics, the paper describes how the establishment of these new biomarkers may lead to improved treatments and less invasive diagnostic procedures.
The complexity of diagnosing IBS
An estimated 25 to 45 million people in the US are affected by IBS. That’s between around 7.7% to 13.8% of the population, demonstrating the prevalence of the illness across the country. Of these people, around 40% have mild IBS, 35% have moderate, and 25% are living with severe cases of the illness.
Also, studies have shown that most people are unfamiliar with the symptoms even though it is one of the most common health problems. What’s more, a recent 2017 study revealed the financial burden of IBS, concluding that it costs around $6,182 per patient, per year, an annual increase of more than $2,000 compared with controls.
Further studies have determined the significant impact that IBS has on quality of life, with sufferers being worse off than those with other chronic disorders, such as asthma or migraines. In particular, anxiety and depression are strongly associated with IBS.
Currently, the exact causes of IBS elude medical professionals, which means that diagnosis can be complicated. The present method for diagnosing IBS includes the extended process of ruling out other potential disorders relating to gut health, such as inflammatory bowel disease.
Also, colonoscopy procedures are often standard for the diagnosis of IBS, which is invasive and costly. There is a real need for the development of new, improved, less invasive and more cost-effective techniques for diagnosing this disorder that impacts a significant portion of the population.
It is this call for better diagnostics that motivated the team at McMaster University. They aimed to develop a technique where biomarkers could be used to detect the illness, which would potentially bypass the need for invasive diagnostic methods, and make diagnosis easier and more accessible. The potential impact of such a technique would lower the cost of treating the disorder, improve on the quality of life of a patient group who have shown to suffer greatly from their symptoms by helping them detect the disorder sooner and allowing them to avoid invasive procedures.
Identification of biomarkers linked with collagen
Metabolic profiling studies were carried out by the team which included the study’s lead author of the study and a professor in McMaster's Department of Chemistry & Chemical Biology, Philip Britz-McKibbin.
To do this, urine samples were collected from a group of patients with IBS, as well as a group of healthy adults who acted as a control group. The team found that the samples of the patient group showed the elevation of specific metabolic signatures, which could potentially be used as biomarkers of the illness.
Overall, multiple metabolites were highlighted, and the scientists found that these particular substances were related to collagen degradation, potentially originating from degradation of the elastic lining in the colon, which may be an underlying cause of IBS.
With the identification of these biomarkers, the team is hopeful that further research may lead to the development of a treatment that uses these biomarkers to not only help diagnose IBS but also may help to monitor the effectiveness of treatment plans, as well as observe the impact of dietary interventions.
Overall, it may help establish more effective therapies for this illness that is known to significantly impact on the quality of life of sufferers.
The McMaster University team is planning to continue their work and will be carrying out further studies intending to identify new biomarkers in urine that could help distinguish between other gut-related diseases of Crohn's disease and ulcerative colitis. They aim to develop biomarker-based diagnoses that would make colonoscopies redundant.
Ballou, S. and Keefer, L. (2016). The impact of irritable bowel syndrome on daily functioning: Characterizing and understanding the daily consequences of IBS. Neurogastroenterology & Motility, 29(4), p.e12982. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367953/#!po=78.5714
Buono, J., Mathur, K., Averitt, A., and Andrae, D. (2017). Economic Burden of Irritable Bowel Syndrome with Diarrhea: Retrospective Analysis of a U.S. Commercially Insured Population. Journal of Managed Care & Specialty Pharmacy, 23(4), pp.453-460. https://www.jmcp.org/doi/10.18553/jmcp.2016.16138
Yamamoto, M., Pinto-Sanchez, M., Bercik, P. and Britz-McKibbin, P. (2019). Metabolomics reveals elevated urinary excretion of collagen degradation and epithelial cell turnover products in irritable bowel syndrome patients. Metabolomics, 15(6). https://link.springer.com/article/10.1007%2Fs11306-019-1543-0