Update on pathogenesis and predictors of response of therapeutic strategies used in inflammatory bowel disease

World J Gastroenterol. 2015 Nov 28;21(44):12519-43. doi: 10.3748/wjg.v21.i44.12519.

Abstract

The search for biomarkers that characterize specific aspects of inflammatory bowel disease (IBD), has received substantial interest in the past years and is moving forward rapidly with the help of modern technologies. Nevertheless, there is a direct demand to identify adequate biomarkers for predicting and evaluating therapeutic response to different therapies. In this subset, pharmacogenetics deserves more attention as part of the endeavor to provide personalized medicine. The ultimate goal in this area is the adjustment of medication for a patient's specific genetic background and thereby to improve drug efficacy and safety rates. The aim of the following review is to utilize the latest knowledge on immunopathogenesis of IBD and update the findings on the field of Immunology and Genetics, to evaluate the response to the different therapies. In the present article, more than 400 publications were reviewed but finally 287 included based on design, reproducibility (or expectancy to be reproducible and translationable into humans) or already measured in humans. A few tests have shown clinical applicability. Other, i.e., genetic associations for the different therapies in IBD have not yet shown consistent or robust results. In the close future it is anticipated that this, cellular and genetic material, as well as the determination of biomarkers will be implemented in an integrated molecular diagnostic and prognostic approach to manage IBD patients.

Keywords: Biomarkers; Mode of action; Mucosal immunology; Pharmacology; Therapeutic drug monitoring.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / pharmacokinetics
  • Anti-Inflammatory Agents / therapeutic use*
  • Biotransformation / genetics
  • Diagnostic Imaging / methods
  • Drug Monitoring / methods*
  • Gastrointestinal Agents / adverse effects
  • Gastrointestinal Agents / pharmacokinetics
  • Gastrointestinal Agents / therapeutic use*
  • Genetic Markers
  • Genetic Predisposition to Disease
  • Humans
  • Inflammation Mediators / immunology
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / genetics
  • Inflammatory Bowel Diseases / immunology
  • Molecular Diagnostic Techniques
  • Phenotype
  • Predictive Value of Tests
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Gastrointestinal Agents
  • Genetic Markers
  • Inflammation Mediators