Biomarker identified that predicts therapeutic success in chronic inflammatory bowel disease

A research team led by Ahmed Hegzay, Charité – Universitätsmedizin Berlin and DRFZ, has identified a biomarker that can predict whether anti-integrin therapy with the drug vedolizumab will be effective in patients with chronic inflammatory bowel disease (IBD) such as Crohn’s disease or ulcerative colitis. As therapies for IBD do not work equally well in all patients, this is a step towards the realisation of successful personalised therapy in IBD patients. The results of the study were recently published in the journal Gastroenterology.

Chronic inflammatory bowel disease is caused by uncontrolled activation of immune cells, such as T cells, in the intestine and occurs in relapses, which makes treatment difficult. The drug vedolizumab specifically blocks T cells to prevent them from entering the intestine. However, it is only effective in two thirds of patients, while one third do not benefit from it at all. In order to predict the success of the treatment, the researchers examined patients before and after starting the therapy using cutting edge analysis methods and machine learning. They identified patterns that predict a response to the therapy.

One key biomarker, the cell division protein Ki67, proved to be reliable: treatment was often unsuccessful in patients with a high number of Ki67-positive T helper cells in their blood, as these cells have no binding sites for vedolizumab and can continue to migrate into the intestine and cause inflammation.

Future studies should confirm the results so that the biomarker can be integrated into clinical routine. In the long term, the aim is to personalised and improve the treatment of chronic inflammatory bowel diseases.