Cornish Jack S, Wirthgen Elisa, Däbritz Jan
University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
Department of Pediatrics, Rostock University Medical Center, Rostock, Germany.
Front Med (Lausanne). 2020 Jan 29;7:8. doi: 10.3389/fmed.2020.00008. eCollection 2020.
The complex nature of inflammatory bowel disease (IBD) often results in treatment failure for many patients. With some patients cycling through multiple therapies before achieving a sustained period of remission, the ability to predict a patient's response to therapeutics could decrease the time from active disease to clinical remission and mucosal healing. The prospect of such individualized treatment of IBD would be aided by accurate biomarkers, both fecal and serological, which have to date shown value as indicators of IBD activity. Here we review the utility of generic biomarkers for inflammation or mucosal healing, such as calprotectin, C-reactive protein (CRP), and fecal hemoglobin (fHb) as predictors of response to treatment of IBD. We further provide a deeper insight into the utility of monitoring the thiopurine treatment by thiopurine metabolites or alternative hematologic parameters. In light of multiple recent publications of biomarkers and biological therapy, our focus in this review is predicting response to thiopurine treatment only, that is, Azathioprine and 6-Mercaptopurine.
炎症性肠病（IBD）的复杂性常常导致许多患者治疗失败。一些患者在实现持续缓解期之前要经历多种治疗，预测患者对治疗反应的能力可以缩短从疾病活动到临床缓解和黏膜愈合的时间。IBD这种个体化治疗的前景将借助准确的生物标志物得到推进，包括粪便和血清学标志物，这些标志物迄今为止已显示出作为IBD活动指标的价值。在此，我们综述了通用的炎症或黏膜愈合生物标志物的效用，如钙卫蛋白、C反应蛋白（CRP）和粪便血红蛋白（fHb）作为IBD治疗反应预测指标的情况。我们还进一步深入探讨了通过硫嘌呤代谢物或替代血液学参数监测硫嘌呤治疗的效用。鉴于近期有多项关于生物标志物和生物治疗的出版物，我们在本综述中的重点仅为预测对硫嘌呤治疗的反应，即硫唑嘌呤和6-巯基嘌呤。
