Lay Summary

Proposal No.  IBD-0015R
Principal Investigator:  Michael B. Wallace, M.D., MPH
Applicant Organization:  Medical University of South Carolina (Charleston, U.S.A.)
Project Title:  Evaluation of spectroscopy for the detection of dysplasia in Interleukin-10-deficient mice with enterocolitis – a pilot study
Period of Award:  December 1, 2002 - August 26, 2003

Aim:  We aim to determine the ability of spectroscopic techniques for the detection of precancerous changes in a mouse model with enterocolitis.

Background:  There is strong evidence that endoscopic screening and surveillance can prevent gastrointestinal cancers when endoscopically visible precancerous lesions (e.g., polyps) are present.  Screening and surveillance of other forms of precancerous lesions as Barrett’s esophagus and inflammatory bowel disease (IBD) may also be helpful, but are limited by many factors such as nonvisible changes, the need for random biopsies, and sampling errors.  Endoscopic spectral methods have the potential to overcome many of these limitations.

Patients with inflammatory bowel disease, either ulcerative colitis or Crohn’s disease, are at increased risk for the development of gastrointestinal carcinoma.  Despite some controversy about the care of these patients, surveillance is widely practiced and recommended.

Methods:  We plan a pilot study with an animal model (IL-10 mice with severe chronic inflammation and precancerous changes in the colon) to get some preliminary data of the role of spectroscopy in this setting and to justify a larger study in humans.

A surgeon will open the entire colon with intact blood supply of the intestine under general anesthesia.  Spectra and corresponding standard biopsies will be collected from the lanced colon.  Precancerous changes will be categorized by consensus diagnosis of two GI pathologists.  The spectral signal will be analyzed at the Massachusetts Institute of Technology (MIT) in Boston.  As control data, we will use biopsies and spectral data from non-precancerous sites.

Foundation criteria:  Although this project is in the early stages of exploration, we have extensive experience with developing TMS for the detection of similar forms of dysplasia in Barrett’s esophagus and colon adenoma.  The TMS is a very new technology and never used in the colon for IBD surveillance.  We believe that spectroscopy will improve the clinical care and effectiveness of surveillance of longstanding IBD by reducing sampling errors of random.