Use of serum biomarkers in a diagnostic test for irritable bowel syndrome

Abstract

SUMMARY BackgroundCurrently, no single serum biomarker can reliably differentiate irritable bowel syndrome (IBS) from other functional gastrointestinal disorders or organic diseases of the gastrointestinal tract.

Validation of the Rome III Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care

“…This suggests that the presence of alarm symptoms in an individual does not predict organic disease with any great accuracy, an issue we have identified in a previous meta-analysis of observational studies. 45 Biomarkers may hold some promise, 46,47 although in the only fully published study to assess these they were no more accurate than existing diagnostic criteria. 48 In the absence of an accurate and accepted biomarker for the condition, and given that our sensitivity analyses using the Rome III criteria did not improve their performance, it would seem that further refinement of the symptoms that are used to define IBS is unlikely to prove fruitful.…”

“…One possibility is to also evaluate patients with colonoscopy and relevant biological markers, as well as obtain a detailed symptom history. 47,49,50 The symptom data can then be compared with the biological markers and colonoscopy results using statistical techniques, such as latent class analysis and Bayesian analysis. 51 These techniques can classify patients into categories based on the underlying structure of the data, without relying on a gold standard.…”

Enhancing Diagnostic Performance of Symptom-Based Criteria for Irritable Bowel Syndrome by Additional History and Limited Diagnostic Evaluation

“…[15][16][17][18][19] Some of the proposed biomarkers (which are unfortunately not widely available) may also serve as therapeutic targets and enhance outcomes. Despite this, a systematic review and meta-analysis that evaluated all generally available approaches to diagnose IBS demonstrated that biomarkers alone performed similarly to symptom-based criteria, 20 while adding to the cost of care.…”

A biomarker panel and psychological morbidity differentiates the irritable bowel syndrome from health and provides novel pathophysiological leads

“…Further work using the sample reported here and based on discovery methods described in this study employing a pathway-based approach as well as genome-wide gene expression profiling has led to the identification of an additional 24 promising biomarkers. This study reports the diagnostic efficacy of the combined 34 markers, 10 identified in the Lembo paper 32 and 24 in this sample.…”

“…A first generation blood-based test for IBS comprising 10 serum biomarkers derived from the literature was reported by Lembo and colleagues 32 ; the panel of 10 biomarkers had acceptable specificity (88%), but poor sensitivity (50%) in differentiating IBS from health. No further studies using this panel have been reported until now, although it is noted that our study compares IBS with health, having excluded organic disease, which stands in contrast to the combination of functional, organic and healthy subjects that made up the earlier study sample.…”