Patients with inflammatory bowel disease often have to wait a long time to find the right medication. But the methods of a large interdisciplinary research team offer hope.
IBD is the common abbreviation for inflammatory bowel disease, which is a group of disorders that cause inflammation in the gut. The most common types of IBD are Crohn’s disease and ulcerative colitis.
These disorders affect more and more people. Today, approximately 40,000 people in Norway have been diagnosed with IBD. The incidence is increasing and is expected to increase to 58,000 people by 2030.
Symptoms of IBD include bloody diarrhea, weight loss, fatigue, and abdominal pain. It is important to determine the correct diagnosis in time so that treatment can begin.”
Ann Elisabet Østvik, a physician specializing in IBD at St. Olavs, Trondheim
It can take years to find the right drug
“Many people have significant symptoms that affect their daily life long before they see their doctor for a check-up, and some become so ill that they need to be admitted to intensive care or, in the worst case scenario, undergo bowel surgery,” says the doctor.
IBD is a lifelong disease. Most patients are diagnosed as teenagers or young adults. Access to more medicines has improved in recent years, but the medicines that work for different patients vary widely. And in IBD patients, there are no biomarkers that can indicate the likelihood that a drug will work.
“Many patients spend several months, and sometimes years, trying and failing before finding the right type of treatment. This greatly affects the quality of life of IBD patients,” says Østvik.
Testing in large numbers – all at once
A research team is now studying how to find the right drug by taking tissue samples from patients’ intestinal lining. Organoids, often called “mini-guts,” are created from these tissue samples, which are then used in drug trials.
Central to the work is a very special laboratory at SINTEF.
“Many scientists use organoids in IBD research, but what’s unique here is that we can compare what we find in our lab experiments to what patients actually experience.”
“In the laboratory, we have a fleet of robots that can collect several patient samples in the same experiment. This way, we can test several samples on a list of drugs that may have different effects. It would be extremely time-consuming to do this work by hand,” says Tonje Husby Haukaas, a SINTEF researcher working on automating the studies.
More precise treatment for each patient
The goal is a colonoscopy study where tissue samples are collected for organoids. These will then be developed and tested by robots.
“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 may also help develop precision medicine for IBD patients.
“The tissue samples are frozen. This means you just have to thaw them when you want to run tests. The system works so that everything is in place to run tests with different drugs,” says Haukaas.
Strong collaboration brings results
The work is done at the research center InTRACC – Gemini Center – NTNU. The Norwegian University of Science and Technology (NTNU), SINTEF and St. Olavs in Trondheim, as well as the University of Oslo, collaborate on their IBD research.
Researchers have been building biobanks for a long time. Patients were followed from the time they were diagnosed. Now researchers have also applied good methods to investigate the effects of drugs, but this is the first time they have been tested on a large scale with patients.
The results are encouraging.
“We’ve seen what drug effects we can detect in organoids grown in the lab, and we can see when they align well with the effects we can see in the patient,” says Torunn Bruland, head of the organoids lab at NTNU.
“Many scientists use organoids in IBD research, but what’s unique here is that we can compare what we find in our lab experiments to what patients actually experience,” adds Bruland.
Worst for children and youth
Doctor Ann Elisabet Østvik emphasizes how important it is to establish faster methods to find the right medicine.
“All the symptoms patients experience lead to a reduced general condition and quality of life. Many cannot go to work or school. They are also affected in critical years of their lives when they have to continue their education and start working,” he says.
Children are particularly vulnerable as these diseases can cause growth retardation and delayed puberty. Some of the symptoms are taboo or embarrassing, which also tends to affect young people more.
The doctor emphasizes that finding an effective treatment for children and adolescents is particularly urgent.
