Using Markers in IBD to Predict Disease and Treatment Outcomes: Rationale and a Review of Current Status

Abstract

Biomarkers, radiology fi ndings, and endoscopic studies, together with clinical assessment of patients with infl ammatory bowel disease, can be used to help determine prognosis, assess disease activity, and increasingly to inform treatment decision-making. This article reviews the current "state of the science" regarding the multitude of different tests that can be performed and how these can be used in the clinic to guide management. Initially, when patients present with symptoms suggestive of infl ammatory bowel disease (IBD), standard endoscopic studies and radiographic studies should be performed and the use of combinations of serologic and fecal markers may additionally be incorporated into patient assessment. Once the patient has a formal diagnosis, prognosis should be assessed and serologic evaluation may be used, but in conjunction with endoscopic and radiographic studies. Within the context of evaluating clinical predictors of disease (e.g., disease location, nutritional status, routine blood tests), early mucosal healing has been linked to better outcomes, and failure to heal the mucosa has been associated with poorer outcomes. Evaluation of response to therapy can be approximated with the use of biomarkers (e.g., C-reactive protein, fecal calprotectin, lactoferrin), and therapeutic drug monitoring has enabled us to assess levels of drug metabolites, drug levels, and antidrug antibodies to guide the ongoing management. Although there is not yet universal adoption of biomarkers to determine treatment choices (e.g., the use of anti-tumor necrosis factor therapy), biomarkers have enabled us to "fi ne tune" treatment of some patients with IBD. Establishing mechanisms of communicating these risks/benefi ts to patients will be a considerable challenge and remains a priority area of research.

Retracted: Utility of the combined use of 3 serologic markers in the diagnosis and monitoring of chronic enteropathies in dogs

“…In humans, use of non-invasive tests enables monitoring disease relapse. 36,37 The selected serological markers are IgA based because they have a short half-life (3-6 days). 38 When conducting serial measurements in enrolled dogs undergoing treatments, our study showed encouraging results, albeit in a limited subcohort, supporting the use of single-assay read outs as a noninvasive tool to monitor disease progression and response to therapy.…”

Pomegranate juice to reduce fecal calprotectin levels in inflammatory bowel disease patients with a high risk of clinical relapse: Study protocol for a randomized controlled trial

“…Routine blood tests (e.g., C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)) are performed to evaluate disease activity [42, 43].…”

Antioxidant Activity of Yogurt Fermented at Low Temperature and Its Anti-inflammatory Effect on DSS-induced Colitis in Mice

“…IBD is divided into two major types, including ulcerative colitis and Crohn’s disease and have been characterized by chronic and recurring intestinal inflammation. (Lichtenstein and McGovern, 2016). The most symptoms of IBD are known to diarrhea, fatigue (Singh et al, 2011), palindrimic inflammation and injury of epithelial tissue (de Moreno de LeBlanc et al, 2015), which leads to reduce of life quality (Simren et al., 2002).…”