Precision medicine in inflammatory bowel disease

Abstract

Inflammatory bowel disease (IBD) is an incurable disease characterized by remission-relapse cycles throughout its course. Both Crohn's disease (CD) and ulcerative colitis (UC), the two main forms of IBD, exhibit tendency to develop complications and substantial heterogeneity in terms of frequency and severity of relapse, thus posing great challenges to the clinical management for IBD. Current treatment strategies are effective in different ways in induction and maintenance therapies for IBD. Recent advances in studies of genetics, pharmacogenetics, proteomics and microbiome provide a strong driving force for identifying molecular markers of prognosis and treatment response, which should help clinicians manage IBD patients more effectively, and then, improve clinical outcomes and reduce treatment costs of patients. In this review, we summarize and discuss precision medicine in IBD, focusing on predictive markers of disease course and treatment response, and monitoring indices during therapeutic drug monitoring.

Suppression of MyD88 disturbs gut microbiota and activates the NLR pathway and hence fails to ameliorate DSS-induced colitis

“…In recent years, the incidence of IBD has increased globally, which brings a rising burden on health care [ 2 ]. Although it is generally accepted that IBD is a result of microbial dysbiosis, exaggerated immune response, disrupted intestinal barrier, and genetic susceptibility, the precise etiology of IBD remains elusive [ 1 , 3 ]. This is the main reason that current therapeutic strategies for IBD show limited efficacy but substantial adverse effects in achieving long-term remission [ 4 ].…”