Bio-Markers of Inflammatory Bowel Disease: Past, Present, and Future

Abstract

Ulcerative colitis (UC) and Crohn's disease (CD) exemplify the two main arms of the spectrum of an idiopathic chronic disease known as inflammatory bowel disease (IBD). To date, this disease remained a puzzling dilemma in many aspects; including difficulties in its etiology/pathogenesis, diagnosis, severity assessment, treatment and outcomes/complications. Physicians usually get the diagnosis of IBD through a combination of clinical features, laboratory tests, radiology, as well as the invasive technique of endoscopy/biopsy. In spite of these efforts, the definite diagnosis can't be established in a significant cohort of cases. This paved the way to searching for laboratory biomarkers that are noninvasive, reproducible, rapid and relatively cheap than other modalities. Unfortunately, we're still far from these ideal biomarkers. Some biomarkers are already being used in daily practice including C-reactive protein (CRP) and fecal calprotectin while others are still in need for confirmation before being applied in clinical practice. In this review article, the authors are going to discuss the past, present, and future utility of biomarkers in IBD. This article aims at highlighting the uses and limitations of all possible current and novel biomarkers in every aspect of the disease from predisposition to prognosis.

Medical significance of simultaneous application of red blood cell distribution width (RDW) and neopterin as diagnostic/prognostic biomarkers in clinical practice

“…provides information about the cellular immune system activation [53][54][55][56]58] for the purpose of diagnosis, successful treatment and prognosis of inflammatory states, including atherosclerosis [56,59,60], malignancies (cancer and leukemia) [61], vascular (cardiovascular-, brain vascular, peripheral artery vascular) [59,62,63], neurological, autoimmune, and many other socially important diseases [e.g. acquired immune deficiency syndrome (AIDS); other viral and bacterial infections], aging-related disorders, including MS [56,57,60,[64][65][66][67][68][69][70].…”

Diagnostic Markers for Nonspecific Inflammatory Bowel Diseases

“…The MPO level in a stool examination has been proved as a noninvasive biomarker for response to treatment in patients with CD and UC [ 70 ]. Studies have shown that a high concentration of MPO after treatment suggests an incomplete response to the treatment [ 73 ].…”

“…Increased M2-PK stool level was also found in pediatric patients with active CD compared to control patients. Pyruvate kinase is a promising sensitive screening tool for intestinal inflammation and its severity indicator [ 73 , 74 ].…”

“…Chen et al also associated CHI3L1 with inflammation of colon epithelial cells leading to cancer modification [ 70 ]. In CD patients, the stool concentration of CHI3L1 was found to be increased in relation to the control group, whereas in UC the concentration of CHI3L1 in the stool correlated with endoscopic activity with high sensitivity and specificity [ 73 ]. Overexpression of CHI3L1 in the large intestine increases the adjacent invasive ability of Escherichia coli in the colon.…”

“…As a proinflammatory cytokine, it seems to play a role in sepsis, atherosclerosis, chronic kidney disease, cancer, IBD, and other autoimmune diseases such as systemic lupus erythematosus and rheumatic diseases [ 73 ]. Studies carried out so far proved that the HMGB1 level assessed in feces examination was significantly higher among children with IBD when compared to the control group.…”