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Fresh hope for patients with chronic inflammatory bowel disease
Patients with inflammatory bowel disease often have to wait a long time to find the right medicine. A new method could transform treatment options.
Inflammatory bowel disease (IBD) is a group of disorders that cause inflammation in the intestine. The most common types of IBD are Crohn’s disease and ulcerative colitis.
These disorders are affecting more and more people.
Today, around 40,000 people in Norway have been diagnosed with IBD. The number of cases is increasing and is expected to reach 58,000 people by 2030.
“IBD symptoms include bloody diarrhoea, weight loss, fatigue, and abdominal pain. It's important to determine the right diagnosis early in order to start treatment,” says Ann Elisabet Østvik, a doctor specialising in IBD at St. Olavs Hospital.
Can take years to find the right medicine
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“A lot of people have significant symptoms that affect their everyday lives long before they see their doctor for an examination, and some become so ill that they have to be admitted for intensive treatment or in the worst case, undergo bowel surgery,” says Østvik.
IBD is a lifelong disease. Most patients are diagnosed as adolescents or young adults.
Access to more medications has improved in recent years, but how well they work differs a lot from one patient to another. For people with IBD, there are still no biomarkers that can show whether a drug is likely to be effective.
“Many patients spend several months, and sometimes years, trying and failing before they find the right type of treatment. This greatly impacts IBD patients’ quality of life,” she says.
Testing in large numbers – all at the same time
A research team is now studying how to find the right medicine by taking tissue samples from patients’ intestinal lining.
Organoids, often called 'mini-intestines,' are created from these tissue samples, which are then used in drug trials.
Central to the work is a very special lab at SINTEF.
“In the lab, we have a fleet of robots that can collect several patient samples in the same experiment. This way, we can test a lot of samples against a list of drugs that can have different effects. It would be extremely time-consuming to do this task manually,” says Tonje Husby Haukaas, a SINTEF researcher who is working on automating the analyses.
More precise treatment for each patient
The goal is to perform a colonoscopy to collect tissue samples for creating organoids. These will then be grown and tested by robots.
“The tests can tell us which drugs are most likely to be effective for individual patients. This will allow us to tailor a more precise treatment for each patient,” says Haukaas.
The method can also help develop precision medicine for IBD patients.
“The tissue samples are frozen. This means that you just have to thaw them when you want to carry out tests. The system functions so that everything is in place to run tests with different drugs,” she explains.
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Strong collaboration yields results
The researchers have been building up the biobanks for a long time. Patients have been followed up from the time they were diagnosed.
They have now also developed good methods for studying the effects of medications, but this is the first time these methods are being tested on a large scale with patients.
The results are encouraging.
“We’ve seen what medication effects we can detect in laboratory-grown organoids, and can observe when they align well with the effects we can see in the patient,” says Torunn Bruland, head of the organoid lab at NTNU.
She explains that while many researchers use organoids in IBD research, what makes their work is unique is the ability to compare lab findings with what patients actually experience.
Worst for children and young people
Ann Elisabet Østvik emphasises how important it is to establish faster methods for finding the right medicine.
“All the symptoms that patients experience lead to a decreased general condition and quality of life. Many are unable to go to work or school. They are also affected in crucial years of their life when they need to pursue their education and start working,” she says.
Children are particularly vulnerable as these diseases can cause stunted growth and delayed puberty.
Some of the symptoms are taboo or embarrassing, which also tends to affect young people the most.
Østvik stresses that finding an effective treatment for children and adolescents is especially urgent.
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