Published online Nov 25, 2015. doi: 10.4253/wjge.v7.i17.1233
Peer-review started: June 18, 2015
First decision: July 27, 2015
Revised: August 14, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: November 25, 2015
Despite significant improvements in our understanding of Crohn’s disease (CD) and ulcerative colitis (UC) in recent years, questions remain regarding the best approaches to assessment and management of these chronic diseases during periods of both relapse and remission. Various serologic biomarkers have been used in the evaluation of patients with both suspected and documented inflammatory bowel disease (IBD), and while each has potential utility in the assessment of patients with IBD, potential limitation remain with each method of assessment. Given these potential shortcomings, there has been increased interest in other means of evaluation of patients with IBD, including an expanding interest in the role of gene expression profiling. Among patients with IBD, gene expression profiles obtained from whole blood have been used to differentiate active from inactive CD, as well as to differentiate between CD, UC, and non-inflammatory diarrheal conditions. There are many opportunities for a non-invasive, blood based test to aid in the assessment of patients with IBD, particularly when considering more invasive means of evaluation including endoscopy with biopsy. Furthermore, as the emphasis on personalized medicine continues to increase, the potential ability of gene expression analysis to predict patient response to individual therapies offers great promise. While whole blood gene expression analysis may not completely replace more traditional means of evaluating patients with suspected or known IBD, it does offer significant potential to expand our knowledge of the underlying genes involved in the development of these diseases.
Core tip: Questions remain regarding the best approaches to the assessment and management of patients with inflammatory bowel disease (IBD) during periods of both relapse and remission. Given the existing limitations of other serologic biomarkers, the development of whole blood gene expression profiling as a non-invasive method of assessment of patients with IBD is appealing. In an era of increased focus on personalized medicine, the potential expansion of our understanding of the genes underlying these diseases and their potential utility in predicting an individual’s disease course or response to therapy offers great promise.