Novel Biomarkers and the Future Potential of Biomarkers in Inflammatory Bowel Disease

Abstract

There is increasing importance placed upon noninvasive assessment of gut inflammation. These tools are likely to be the key in differentiating intestinal inflammatory disease from functional disorders and in monitoring the response to intervention in individuals with known inflammatory conditions. Although various noninvasive markers are currently available, they have limitations and do not provide ideal utility. This review focuses on emerging markers of gut inflammation, highlighting the potential of specific markers.

Clinical utility of currently available biomarkers in inflammatory enteropathies of dogs

“…Because a single biomarker is very unlikely to satisfy all of these goals, it is very important to consider what clinical information is expected to be gained from using a specific biomarker, and in what clinical situation it will serve as a good surrogate marker for existing algorithms (eg, definition of baseline disease activity, response to treatment, or maintenance of clinical remission) to improve diagnostic decision making, treatment recommendations, patient monitoring, or even prophylactic measures (Table 1). 11, 12, 13 …”

“…Biomarkers that could be clinically useful in dogs with CIE are markers that reflect the individual risk to develop CIE, evaluate gastrointestinal function (ie, digestion, absorption, secretion, or a combination of these), aid in diagnosing the inflammatory disease process, indicate disease activity or severity, predict individual response to specific forms of treatment or disease outcome, monitor the severity of gastrointestinal inflammation, or even a combination of these 12, 13, 14. The utility of a marker in routine clinical practice also requires that it be easy to evaluate, inexpensive, and minimally invasive, in addition to being stable in routine biological specimens under clinical conditions 11…”

“…Specificity for the gastrointestinal tract (ie, organ‐specific expression or by type of specimen) would be another desirable characteristic for which fecal biomarkers hold great promise 12, 13, 17…”

“…11,14 Because a single biomarker is very unlikely to satisfy all of these goals, it is very important to consider what clinical information is expected to be gained from using a specific biomarker, and in what clinical situation it will serve as a good surrogate marker for existing algorithms (eg, definition of baseline disease activity, response to treatment, or maintenance of clinical remission) to improve diagnostic decision making, treatment recommendations, patient monitoring, or even prophylactic measures (Table 1). [11][12][13] 2.2 | Classification of biomarkers Disease biomarkers are either static or dynamic, and based on the desired characteristics described above, they typically are subclassified as functional, biochemical, cellular, genomic, proteomic, metabolomic, microbiomic, behavioral, or outcome biomarkers. [14][15][16] Of these, functional, biochemical, and genomic biomarkers currently are the most practical to use and most widely available and are currently of particular clinical interest for CIE management in dogs ( Figure 1).…”

“…11,14 Specificity for the gastrointestinal tract (ie, organ-specific expression or by type of specimen) would be another desirable characteristic for which fecal biomarkers hold great promise. 12,13,17 Biochemical markers that have been evaluated in dogs with CIE with improved sensitivity for lower serum CRP concentrations 89,90 currently is not routinely available in veterinary medicine. 91 High biological variability of serum CRP concentrations in dogs 92 limits its utility as a diagnostic biomarker in dogs with CIE. Serum CRP appears to be clinically more useful as a surrogate marker to assess disease progression and response to treatment in dogs with CIE, 8,50,[93][94][95] although some studies did not find a relationship with the severity of clinical signs or histologic lesions.…”