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World J Gastroenterol. Jun 7, 2010; 16(21): 2616-2625
Published online Jun 7, 2010. doi: 10.3748/wjg.v16.i21.2616
Mucosal biomarkers in inflammatory bowel disease: Key pathogenic players or disease predictors?
Franco Scaldaferri, Carmen Correale, Antonio Gasbarrini, Silvio Danese
Franco Scaldaferri, Antonio Gasbarrini, Department of Internal Medicine, Catholic University of Rome, 00168 Rome, Italy
Carmen Correale, Silvio Danese, Division of Gastroenterology, IRCCS, Istituto Clinico Humanitas, 20089 Rozzano, Milan, Italy
Author contributions: Scaldaferri F and Danese S did the literature review and wrote the paper; Correale C did the paper revision and editing; Gasbarrini A made suggestions and offered support.
Correspondence to: Silvio Danese, MD, PhD, Division of Gastroenterology, IRCCS, Istituto Clinico Humanitas, 20089 Rozzano, Milan, Italy. sdanese@hotmail.com
Telephone: +39-2-82244771 Fax: +39-2-82245101
Received: November 16, 2009
Revised: December 28, 2009
Accepted: January 4, 2010
Published online: June 7, 2010
Abstract

Inflammatory bowel diseases (IBDs) are chronic inflammatory disorders of the bowel, including ulcerative colitis and Crohn’s disease. A single etiology has not been identified, but rather the pathogenesis of IBD is very complex and involves several major and minor contributors, employing different inflammatory pathways which have different roles in different patients. Although new and powerful medical treatments are available, many are biological drugs or immunosuppressants, which are associated with significant side effects and elevated costs. As a result, the need for predicting disease course and response to therapy is essential. Major attempts have been made at identifying clinical characteristics, concurrent medical therapy, and serological and genetic markers as predictors of response to biological agents. Only few reports exist on how mucosal/tissue markers are able to predict clinical behavior of the disease or its response to therapy. The aim of this paper therefore is to review the little information available regarding tissue markers as predictors of response to therapy, and reevaluate the role of tissue factors associated with disease severity, which can eventually be ranked as “tissue factor predictors”. Five main categories are assessed, including mucosal cytokines and chemokines, adhesion molecules and markers of activation, immune and non-immune cells, and other mucosal components. Improvement in the design and specificity of clinical studies are mandatory to be able to classify tissue markers as predictors of disease course and response to specific therapy, obtain the goal of achieving “personalized pathogenesis-oriented therapy” in IBD.

Keywords: Inflammatory bowel disease; Crohn’s disease; Ulcerative colitis; Disease course predictors; Cytokines; Chemokines; Intestinal mucosa