Breaking boundaries in inflammatory bowel disease diagnosis with insights from the gut microbiome

Zheng J, Sun Q, Zhang M, et al. Non-invasive, microbiome-based diagnosis of inflammatory bowel disease. Nat Med 2024. doi: 10.1038/s41591-024-03280-4.

With the growing emphasis on precision medicine, there has been a focus on the discovery of reliable biomarkers for IBD. This study Zheng et al, investigate a novel microbiome-based diagnostic approach for IBD. Using metagenomic data from 5979 faecal samples, they identified specific bacterial species that can differentiate patients with IBD from healthy controls. Diagnostic models incorporating these species achieved and area under the curve (AUC) greater than 0.90 in both the discovery and validation cohorts, significantly outperforming traditional markers like faecal calprotectin. A multiplex droplet digital polymerase chain reaction (m-ddPCR) method targeting selected bacterial biomarkers demonstrated a higher sensitivity and specificity in diagnosing IBD compared with conventional methods. Furthermore, the bacterial species identified were consistent across various ethnic groups, suggesting a potential for global applicability with diagnostic models maintaining high accuracy in both active and inactive disease states.

Another finding of the study was that both UC and Crohn’s disease (CD) are associated with significant disruptions in metabolic pathways including amino acid biosynthesis and lipid metabolism that could be linked to altered microbial composition. These disruptions correlated with shifts in microbial composition, suggesting a vital role for the microbial changes in IBD pathogenesis.

This study represents a significant advancement in the quest for non-invasive diagnostic biomarkers of IBD and underscore the potential of leveraging the gut microbiome not only as diagnostic tools but also as possible therapeutic targets, paving the way for more personalised treatment strategies in the management of patients with IBD.

The conundrum of post Bariatric surgery hypoglycaemia: a serotonin story

Ferraz-Bannitz R, Ozturk B, Cummings C, et al. Postprandial metabolomics analysis reveals disordered serotonin metabolism in post-bariatric hypoglycemia. J Clin Invest 2024; e180157. doi: 10.1172/JCI180157.

Hypoglycaemia occurs in 30% of patient following Roux-en-Y bariatric …