Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 25, 2015; 7(17): 1233-1237
Published online Nov 25, 2015. doi: 10.4253/wjge.v7.i17.1233
Use of blood based biomarkers in the evaluation of Crohn’s disease and ulcerative colitis
Edward L Barnes, Choong-Chin Liew, Samuel Chao, Robert Burakoff
Edward L Barnes, Robert Burakoff, Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, Boston, MA 02115, United States
Choong-Chin Liew, Golden Health Diagnostics, Inc., Toronto, Ontario M4N 3M5, Canada
Samuel Chao, GeneNews, Toronto, Ontario M4N 3M5, Canada
Author contributions: Barnes EL conceived the issues which formed the content of the manuscript and drafted the manuscript; Liew CC, Chao S, and Burakoff R conceived the issues which formed the contents of the manuscript and made critical revisions to the content of the manuscript; all authors approved the final version of this manuscript.
Supported by National Institutes of Health T32 Training Grant, No. T32 DK007533-29.
Conflict-of-interest statement: The authors have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Edward L Barnes, MD, Research/Clinical Fellow in Gastroenterology, Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, United States. ebarnes1@partners.org
Telephone: +1-617-7326389 Fax: +1-617-5660338
Received: June 16, 2015
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.

Keywords: Inflammatory bowel disease, Ulcerative colitis, Gene expression analysis, Whole blood gene expression analysis, Biomarkers, Crohn’s disease, Gene profiling

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.