Like a peephole, through which to monitor the health of the intestine, to support disease diagnosis, check the post-operative progress or the effectiveness of therapies. Or even to be used as a permanent sentinel capable of promptly intercepting local inflammation and thus adjusting the therapy. Avoiding the use of the operating room to eliminate excessively damaged tissues. These are the promises for a new sensor: a monitoring system designed for people with chronic intestinal inflammatory diseases, such as Crohn’s and ulcerative colitis. For now the device has only been tested in animal models of the disease, but their creators from Northwestern University they think already trying it on human tissues. The details of their work were published are Nature Biomedical Engineering.
Chronic intestinal inflammatory diseases
Crohn’s and ulcerative colitis are inflammatory diseases of the gastrointestinal system. They share an inflammatory basis, some symptoms (abdominal pain, tiredness, weight loss, bloody diarrhea, especially in ulcerative colitis) and a fluctuating trend, characterized by exacerbations and remissions. At Northwerstern University, however, they believe that it is possible to contain flare-ups by monitoring the state of internal inflammation, even before it gives rise to symptoms and heavily damages the tissues.
The heat and inflammation sensor
Researchers have developed a wireless sensor capable of intercepting early signs of inflammation. It is in fact a thermometer – inflammation in fact increases the temperature – just a few millimeters large which, positioned along the intestine or in the relevant sections of the gastrointestinal system (Crohn’s and colitis tend to affect different areas), monitors any changes in real time. Tested on mice, it works, that is, it signals temperature variations correlated with variations in stress levels and markers of inflammation in the blood. And it does so by anticipating the visual appearance of the lesions by approximately 5 weeks. However, when the temperature drops in the long term, explained Surabhi Madhvapathy, first author of the work, the signal is a generic degradation of the tissues. It is plausible, the authors add, that a similar system also signals temperature changes not directly associated with inflammation – just think of physical exercise or an increase in environmental temperature – but scientists believe that it is possible to discriminate the different types of data. That said, could a sensor like this work in humans?
Remote monitoring
Yes, or rather, we don’t know if this will exactly be the winning device, but it is likely that in the future we will have similar devices to monitor the progress of Crohn’s disease. Manuela Merli, full professor of gastroenterology at the Department of Translational Medicine and Precision at the Sapienza University of Rome and medical director at the Gastroenterology of the Policlinico Umberto I (among the “Hospitals of excellence” for gastroenterology) is convinced of this. “In recent years we have been witnessing an exponential growth in devices that help patients monitor themselves and doctors follow them. Just think of the opportunities offered today by blood sugar monitoring systems for diabetics, within the reach of smartphones, and which can be consulted remotely by doctors. We ourselves are working with an electrochemical device for the evaluation of patients through stool analysis”, recalls Merlo.
A device that allows patients to “self-monitor”
The advantages of similar monitoring tools for Crohn’s patients are clear: “To observe internal inflammation we must resort to endoscopy, but we cannot continuously conduct these exams – continues Merli – a system that allows us to obtain information by measuring the increase in temperature, could instead help the patient to self-monitor, without resorting to numerous visits and tests. An advantage especially considering the chronic nature of the disease, which affects around 150 thousand people, mostly young people.” Continuous monitoring would thus allow doctors to modulate therapies, intervening before damage begins: “For example, if in some cases there have been no signs of illness for some time, therapies could be reduced, or on the contrary we could think about re-dosing the medications in case the inflammation returns,” concludes the expert.