Biomarkers for Inflammatory Bowel Disease

Kevin F Foley; Patricia Kao

doi:10.29074/ascls.20.2.84

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Kevin F Foley, PhD⇑
1. is a faculty member in the Department of Pathology and Laboratory Medicine, The Mayo Clinic, Rochester MN
Patricia Kao, MD
1. is a gastroenterology fellow at Fletcher Allen Health Care, Burlington VT

Address for correspondence: Kevin Foley PhD, Department of Pathology and Laboratory Medicine, The Mayo Clinic, 200 First Street SW, Rochester MN 55905. (507) 538-6357. foley.kevin{at}mayo.edu.

Extract

Over the past ten years, the field of gastroenterology has seen the rapid development of commercially available diagnostic serological tests for a variety of intestinal diseases. Laboratory assays are routinely used to help diagnose conditions such as celiac disease, H. pylori infection, malabsorption, colon cancer, Zollinger Ellison syndrome, and others. More recently, biomarkers used to assist in the diagnosis of inflammatory bowel disease (IBD) have been studied. IBD refers to a het erogeneous group of disorders of unclear etiology but sharing common histopathological features. IBD patients have chronic intestinal mucosal inflammation at the microscopic level with the potential for macroscopic and extra-intestinal inflammation. IBD is divided into three entities: ulcerative colitis (UC), Crohn's disease (CD), and indeterminate colitis. UC is a chronic inflammatory disorder of the colonic mucosa which occurs from the anus and can extend proximally to involve the entire colon. In contrast, CD is a chronic inflammatory disorder that can occur anywhere from the mouth to the anus in a patchy distribution, involving the full thickness of the intestine. Currently, despite complete clinical, endoscopic, radiologic, and pathologic evaluations, 10% to 15% of adult patients with IBD cannot be differentiated; these patients fall into the category of indeterminate colitis. The clinical importance of distinguishing CD from UC is threefold: (1) defining pathogenesis, (2) guiding treatment regimens, and (3) predicting prognosis. The Crohn's and Colitis Foundation of America estimates that approximately one million Americans have IBD, evenly distributed between CD and UC, with ten percent classified as having indeterminate colitis.

ABBREVIATIONS: ASCA = Anti-Saccharomyces cervisiae antibodies; CD = Crohn's disease; CRP = C-reactive protein; ELISA = enzyme-linked immunosorbant assay; IBD = inflammatory bowel disease; pANCA = perinuclear anti-neutrophilic cytoplasmic antibody; PPV = positive predictive value; UC = ulcerative colitis.