Identification and validation of a blood- based diagnostic lipidomic signature of pediatric inflammatory bowel disease.
Salihovic S., Nyström N., Mathisen CB-W., Kruse R., Olbjørn C., Andersen S., Noble AJ., Dorn-Rasmussen M., Bazov I., Perminow G., Opheim R., Detlie TE., Huppertz-Hauss G., Hedin CRH., Carlson M., Öhman L., Magnusson MK., Keita ÅV., Söderholm JD., D'Amato M., Orešič M., Wewer V., Satsangi J., Lindqvist CM., Burisch J., Uhlig HH., Repsilber D., Hyötyläinen T., Høivik ML., Halfvarson J.
Improved biomarkers are needed for pediatric inflammatory bowel disease. Here we identify a diagnostic lipidomic signature for pediatric inflammatory bowel disease by analyzing blood samples from a discovery cohort of incident treatment-naïve pediatric patients and validating findings in an independent inception cohort. The lipidomic signature comprising of only lactosyl ceramide (d18:1/16:0) and phosphatidylcholine (18:0p/22:6) improves the diagnostic prediction compared with high-sensitivity C-reactive protein. Adding high-sensitivity C-reactive protein to the signature does not improve its performance. In patients providing a stool sample, the diagnostic performance of the lipidomic signature and fecal calprotectin, a marker of gastrointestinal inflammation, does not substantially differ. Upon investigation in a third pediatric cohort, the findings of increased lactosyl ceramide (d18:1/16:0) and decreased phosphatidylcholine (18:0p/22:6) absolute concentrations are confirmed. Translation of the lipidomic signature into a scalable diagnostic blood test for pediatric inflammatory bowel disease has the potential to support clinical decision making.