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URINARY METABOLOMIC PROFILES DIFFER BETWEEN PATIENTS WITH AND WITHOUT INFLAMMATORY BOWEL DISEASE
JS Siffledeen1, H Fu2, CM Slupsky2, RN Fedorak1
1Division of Gastroenterology, 2Department of Medicine, University of Alberta, Edmonton
INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic debilitating disorder that is initiated and sustained through both genetic and environmental factors. Indeed, commensal microflora have been shown to play a key role in both Crohn’s disease (CD) and ulcerative colitis (UC). Metabolomics is the study of perturbations in small molecule metabolites due to an external stress. Analysis of urinary metabolite profiles can differentiate individuals with common and/or different commensal bacteria fingerprints.
AIM: In the current study, we examined urinary metabolomic profiles to differentiate patients with IBD and those without IBD.
METHODS: Patients attending a university IBD clinic were sequentially consented and a spot urine sample for analysis and a Harvey Bradshaw Index (HBI) or Modified Mayo score for disease activity obtained. Metabolite concentrations were derived from analysis of 600 MHz Nuclear Magnetic Resonance (NMR) spectra, and both univariate and multivariate statistical techniques were applied to the resulting data. Results for patients with CD and UC were compared to age and gender matched controls.
RESULTS: We observed clear differences in urinary metabolite profiles between individuals with IBD and healthy controls (78% sensitivity and 89% specificity on a blinded test set). Furthermore, within the IBD group, we were able to distinguish CD from UC. UC and CD disease activity was reflected in the metabolite profiles.
CONCLUSION: This study illustrates that urinary metabolomics is effective at distinguishing IBD patients from normal subjects, and can also distinguish CD from UC. This methodology represents a novel diagnostic tool for IBD that has enormous potential to provide insight into IBD pathogenesis.