Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s disease

Background: Crohn’s disease is characterised by multifaceted changes in gut function, involving not just inflammatory effects but also alterations in gut barrier function and gastric motility. However, current diagnostic tools used to measure key gut functional parameters are invasive, unreliable or...

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Main Authors: Jonathan Gan, Qian Chen, Elena Monfort Sanchez, Nilanjan Mandal, Jiacheng Xu, Zixin Wang, Arjun Agarwal, Emmanuel Oluwatunmise, Pratik Ramkumar, Ash Salam, Elena Chekmeneva, María Gómez-Romero, Lynn Maslen, Sharmili Balarajah, Robert Perry, Karl King Yong, Jonathan Hoare, Nick Powell, James Alexander, James Avery, Hutan Ashrafian, Ara Darzi, Alex J. Thompson
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Therapeutic Advances in Gastroenterology
Online Access:https://doi.org/10.1177/17562848251361634
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author Jonathan Gan
Qian Chen
Elena Monfort Sanchez
Nilanjan Mandal
Jiacheng Xu
Zixin Wang
Arjun Agarwal
Emmanuel Oluwatunmise
Pratik Ramkumar
Ash Salam
Elena Chekmeneva
María Gómez-Romero
Lynn Maslen
Sharmili Balarajah
Robert Perry
Karl King Yong
Jonathan Hoare
Nick Powell
James Alexander
James Avery
Hutan Ashrafian
Ara Darzi
Alex J. Thompson
author_facet Jonathan Gan
Qian Chen
Elena Monfort Sanchez
Nilanjan Mandal
Jiacheng Xu
Zixin Wang
Arjun Agarwal
Emmanuel Oluwatunmise
Pratik Ramkumar
Ash Salam
Elena Chekmeneva
María Gómez-Romero
Lynn Maslen
Sharmili Balarajah
Robert Perry
Karl King Yong
Jonathan Hoare
Nick Powell
James Alexander
James Avery
Hutan Ashrafian
Ara Darzi
Alex J. Thompson
author_sort Jonathan Gan
collection DOAJ
description Background: Crohn’s disease is characterised by multifaceted changes in gut function, involving not just inflammatory effects but also alterations in gut barrier function and gastric motility. However, current diagnostic tools used to measure key gut functional parameters are invasive, unreliable or time-consuming. Thus, we applied a novel, non-invasive fluorescence sensing technology – transcutaneous fluorescence spectroscopy (TFS) – to investigate gut barrier function and gastric emptying in Crohn’s disease. Objectives: Our study aimed to validate TFS for non-invasive gastrointestinal (GI) diagnostics and to explore changes in gut barrier function and gastric emptying rate simultaneously in Crohn’s disease. Design: A cross-sectional study involving patients with Crohn’s disease and healthy individuals. Methods: We performed fluorescent measurements and lactulose:mannitol (L:M) tests in 38 Crohn’s disease patients and 20 healthy volunteers. We investigated multiple TFS-derived parameters as indicators of gut barrier function and gastric emptying rate. Using these parameters, we assessed differences between healthy volunteers, inactive Crohn’s patients and active Crohn’s patients, and calculated correlations between TFS and L:M values. Results: TFS-derived parameters revealed significantly increased intestinal permeability and delayed gastric emptying in patients with active Crohn’s compared to healthy controls. TFS trends showed encouraging alignment with those from the L:M test, suggesting potential concordance with established methods. No adverse events were reported. Conclusion: TFS enables rapid, non-invasive discrimination of Crohn’s patients from healthy volunteers and allows simultaneous assessment of gut barrier function and gastric emptying rate – two important aspects of GI function in Crohn’s disease. This implies potential for improved monitoring and diagnosis of Crohn’s disease (and other gut disorders) as well as more advanced study of gut function in health and disease. Trial registration: The clinical study reported in this article was registered with ClinicalTrials.gov prior to enrolment of the first participant. https://clinicaltrials.gov/study/NCT03434639 and Registration number: NCT03434639.
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spelling doaj-art-28a3eba5bbf748ec9ae9e48a1fa8dca72025-08-20T03:04:55ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-08-011810.1177/17562848251361634Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s diseaseJonathan GanQian ChenElena Monfort SanchezNilanjan MandalJiacheng XuZixin WangArjun AgarwalEmmanuel OluwatunmisePratik RamkumarAsh SalamElena ChekmenevaMaría Gómez-RomeroLynn MaslenSharmili BalarajahRobert PerryKarl King YongJonathan HoareNick PowellJames AlexanderJames AveryHutan AshrafianAra DarziAlex J. ThompsonBackground: Crohn’s disease is characterised by multifaceted changes in gut function, involving not just inflammatory effects but also alterations in gut barrier function and gastric motility. However, current diagnostic tools used to measure key gut functional parameters are invasive, unreliable or time-consuming. Thus, we applied a novel, non-invasive fluorescence sensing technology – transcutaneous fluorescence spectroscopy (TFS) – to investigate gut barrier function and gastric emptying in Crohn’s disease. Objectives: Our study aimed to validate TFS for non-invasive gastrointestinal (GI) diagnostics and to explore changes in gut barrier function and gastric emptying rate simultaneously in Crohn’s disease. Design: A cross-sectional study involving patients with Crohn’s disease and healthy individuals. Methods: We performed fluorescent measurements and lactulose:mannitol (L:M) tests in 38 Crohn’s disease patients and 20 healthy volunteers. We investigated multiple TFS-derived parameters as indicators of gut barrier function and gastric emptying rate. Using these parameters, we assessed differences between healthy volunteers, inactive Crohn’s patients and active Crohn’s patients, and calculated correlations between TFS and L:M values. Results: TFS-derived parameters revealed significantly increased intestinal permeability and delayed gastric emptying in patients with active Crohn’s compared to healthy controls. TFS trends showed encouraging alignment with those from the L:M test, suggesting potential concordance with established methods. No adverse events were reported. Conclusion: TFS enables rapid, non-invasive discrimination of Crohn’s patients from healthy volunteers and allows simultaneous assessment of gut barrier function and gastric emptying rate – two important aspects of GI function in Crohn’s disease. This implies potential for improved monitoring and diagnosis of Crohn’s disease (and other gut disorders) as well as more advanced study of gut function in health and disease. Trial registration: The clinical study reported in this article was registered with ClinicalTrials.gov prior to enrolment of the first participant. https://clinicaltrials.gov/study/NCT03434639 and Registration number: NCT03434639.https://doi.org/10.1177/17562848251361634
spellingShingle Jonathan Gan
Qian Chen
Elena Monfort Sanchez
Nilanjan Mandal
Jiacheng Xu
Zixin Wang
Arjun Agarwal
Emmanuel Oluwatunmise
Pratik Ramkumar
Ash Salam
Elena Chekmeneva
María Gómez-Romero
Lynn Maslen
Sharmili Balarajah
Robert Perry
Karl King Yong
Jonathan Hoare
Nick Powell
James Alexander
James Avery
Hutan Ashrafian
Ara Darzi
Alex J. Thompson
Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s disease
Therapeutic Advances in Gastroenterology
title Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s disease
title_full Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s disease
title_fullStr Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s disease
title_full_unstemmed Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s disease
title_short Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s disease
title_sort non invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first in human study of crohn s disease
url https://doi.org/10.1177/17562848251361634
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