Ulcerative colitis: Infrared diagnostics

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  • Published: May 1, 2016
  • Author: David Bradley
  • Channels: Infrared Spectroscopy
thumbnail image: Ulcerative colitis: Infrared diagnostics

Inflammatory response

Endoscopic image of ulcerative colitis showing loss of vascular pattern of the sigmoid colon, granularity and some friability of the mucosa. Credit: Wiki/Samir 2006

Infrared technology could be key to minimally invasive screening for an often debilitating and worrying condition, ulcerative colitis. Moreover, the technology could offer a rapid, simpler and cost-effective diagnostic method that precludes the need for surgical biopsies and intrusive testing of the body, according to researchers at Georgia State University.

Details of the new approach were published in the Journal of Biophotonics by Jitto Titus, Emilie Viennois, Didier Merlin, and Unil Perera. The technique involves testing very small amounts (1 microlitre) of serum, the clear liquid separated from whole blood, for the presence of raised levels of mannose (D-mannopyranose) using attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy, which requires minimal sample preparation. Mannose is a sugar known to be a useful biomarker for colitis.

Ulcerative colitis is a form of inflammatory bowel disease (IBD) that is associated with chronic inflammation and ulcers in the colon, the largest section of the large intestine. The disease leads to diarrhoea and blood loss from the bowel. It is not yet known what causes ulcerative colitis, nor the closely related Crohn's disease (which can affect the whole of the gastrointestinal tract, rather than just the colon and rectum).However, as with many idiopathic diseases medical researchers suspect a genetic component. There are 1 to 20 new cases diagnosed per 100,000 people each year and about 8 to 246 per 100,000 individuals have the condition at any given time. IBD is a known risk factor for colorectal cancer. Of course, many more may suffer in silence and are undiagnosed or misdiagnosed.

Simpler diagnostics

"We found that ATR-FTIR spectroscopy is an effective tool for detecting colitis in the serum of mice," explains physicist Perera from GSU's Center for Nano-Optics. "This rapid, simple, cost-effective and minimally invasive technique could be further developed into a personalized diagnostic tool that would assess disease status based on an individual's molecular composition and allow for personalized diagnosis and drug management. Perhaps this technology could be integrated into a portable device, such as the glucometer used by patients with diabetes."

Avoiding colonoscopy

Colonoscopy is the usual diagnostic tool in bowel conditions. But, few patients and clinicians would wish to use it in a regular check-up not least because of its invasive nature, the need for sedation and the cost. "Patients usually do not like to go through [colonoscopy] as it is pretty uncomfortable and often postpone the tests, hence a simple blood test like screening can be merged into a simple blood test as a routine test," Perera told SpectroscopyNOW. As such, there has been a pressing need for a simpler, inexpensive and low-risk diagnostic tool for IBD. GSU biomedical researcher Didier Merlin, who also holds a position at the Atlanta Veterans Affairs Medical Center suggests that, "Infrared spectroscopy has greatly enhanced clinical medicine in the last two decades and shows promise as a solution."

The team tested their approach on two groups of mice. The first group were mice with targeted deletion of the interleukin 10 (IL10) gene, known as interleukin 10 knockout (IL10-/-) mice, which are known to develop colitis through T helper immune cells. Disease in these mice looks very much like chronic colitis in people in terms of its physiological, histological and biochemical characteristics. For the second group, colitis was triggered by administering dextran sodium sulfate. Colitis in these mice more closely resembles ulcerative colitis in humans. For both groups, faeces. The blood serum samples were tested using ATR-FTIR spectroscopy while the faeces were tested for elevated levels of lipocalin-2 protein, an established marker for colitis, thus corroborating the spectroscopic finding, Perera told us. There was, of course, a third group of mice that were also tested, the control group, members of which did not have any form of colitis. ATR-FTIR spectroscopy quickly and effectively identifies raised serum levels of mannose in the colitis groups.

Related Links

J Biophotonics, 2016, online: "Minimally invasive screening for colitis using attenuated total internal reflectance fourier transform infrared spectroscopy"

Article by David Bradley

The views represented in this article are solely those of the author and do not necessarily represent those of John Wiley and Sons, Ltd.

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