Mendoza J L, Abreu M T
Hospital Clinico San Carlos, Madrid, Spain.
Gastroenterol Clin Biol. 2009 Jun;33 Suppl 3:S158-73. doi: 10.1016/S0399-8320(09)73151-3.
The biomarkers are important in the Inflammatory Bowel Disease (IBD) to gain an objective measurement of disease activity and severity, as well as prognostic indicator and outcome of therapy. And they can be helpful to avoid invasive procedures. The ideal biomarker does not exist for IBD and it is likely that more than one biomarker will be needed. Biological markers potentially useful in IBD include acute-phase proteins, fecal markers, several antibodies and novel genetic determinants. The C-reactive protein (CRP) is the most studied and has been shown to be an objective marker of inflammation. CRP is a good marker of measuring disease activity in Crohn's disease (CD) and its levels can be used to guide therapy. The fecal markers (calprotectin and lactoferrin) may be helpful in differentiating patients with IBD from those with functional disorders and to predict clinical relapse. The panel of serologic markers (anti-Saccharomyces cerevisiae antibody, perinuclear anti-neutrophil cytoplasmic antibody, anti-OmpC and anti-I2 and antiglycan antibodies) for IBD can be used to stratify IBD patients into more homogeneous subgroups with respect to disease progression. Correlating serologic markers with genotypes and clinical phenotypes should enhance our understanding of the pathophysiology of IBD. The development of biomarkers in IBD will be very important in the future with the increasing utilization of novel methodological approaches like genomics and proteomics.
生物标志物在炎症性肠病(IBD)中对于客观测量疾病活动度和严重程度、作为预后指标以及评估治疗结果非常重要。并且它们有助于避免侵入性检查。IBD不存在理想的生物标志物,可能需要不止一种生物标志物。在IBD中可能有用的生物标志物包括急性期蛋白、粪便标志物、几种抗体和新的遗传决定因素。C反应蛋白(CRP)是研究最多的,已被证明是炎症的客观标志物。CRP是测量克罗恩病(CD)疾病活动度的良好标志物,其水平可用于指导治疗。粪便标志物(钙卫蛋白和乳铁蛋白)可能有助于区分IBD患者与功能性疾病患者,并预测临床复发。用于IBD的血清学标志物组合(抗酿酒酵母抗体、核周抗中性粒细胞胞浆抗体、抗OmpC和抗I2以及抗聚糖抗体)可用于根据疾病进展将IBD患者分层为更同质化的亚组。将血清学标志物与基因型和临床表型相关联应能增强我们对IBD病理生理学的理解。随着基因组学和蛋白质组学等新方法的应用日益增加,IBD生物标志物的开发在未来将非常重要。
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