Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan,
Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Digestion. 2023;104(1):30-41. doi: 10.1159/000527846. Epub 2022 Nov 18.
BACKGROUND: Mucosal healing (MH) was proposed to be an ideal treatment goal for patients with inflammatory bowel disease (IBD). Instead of endoscopy to confirm MH, biomarkers are frequently used and have become an indispensable modality for the clinical examination of patients with IBD. SUMMARY: Common biomarkers of IBD include C-reactive protein (CRP), erythrocyte sedimentation rate, antineutrophil cytoplasmic antibodies, anti-Saccharomyces cerevisiae antibodies, leucine-rich α2 glycoprotein, fecal calprotectin (FCP), and the fecal immunochemical test. Biomarkers play five major roles in the management of IBD: (1) diagnosing and distinguishing between IBD and non-IBD or ulcerative colitis and Crohn's disease; (2) predicting treatment response, especially before administrating biologics; (3) monitoring and grasping endoscopic or histological disease activity; (4) replacing endoscopy for diagnosing MH, including endoscopic and histological remission; and (5) predicting recurrence before disease activity appears through symptoms. Many reports have demonstrated the usefulness of CRP and FCP for those five roles; however, they have limitations for diagnosing MH or predicting treatment response. In general, FCP has better ability in those positions than CRP; additionally, leucine-rich α2 glycoprotein can diagnose endoscopic disease activity better than CRP. The novel biomarker, prostaglandin E-major urinary metabolite, and anti-αvβ6 antibody are expected to be noninvasive and reliable biomarkers; however, more evidence is required for future studies. Oncostatin M and microRNA are also prospects, in addition to other familiar and novel biomarkers. KEY MESSAGES: Each biomarker has a useful feature; therefore, we should consider their features and use appropriate biomarkers for the five roles to enable noninvasive and smooth management of IBD.
背景:黏膜愈合(MH)被提议作为炎症性肠病(IBD)患者的理想治疗目标。替代内镜来确认 MH,生物标志物经常被使用,并已成为 IBD 患者临床检查不可或缺的方式。
摘要:IBD 的常见生物标志物包括 C 反应蛋白(CRP)、红细胞沉降率、抗中性粒细胞胞浆抗体、抗酿酒酵母抗体、富含亮氨酸的α2 糖蛋白、粪便钙卫蛋白(FCP)和粪便免疫化学试验。生物标志物在 IBD 的管理中发挥着五个主要作用:(1)诊断和区分 IBD 与非 IBD 或溃疡性结肠炎与克罗恩病;(2)预测治疗反应,特别是在给予生物制剂之前;(3)监测和掌握内镜或组织学疾病活动;(4)通过症状预测疾病活动出现之前的复发,用替代内镜来诊断 MH,包括内镜和组织学缓解;(5)替代内镜来诊断 MH,包括内镜和组织学缓解。许多报告表明 CRP 和 FCP 对这五个作用有用;然而,它们在诊断 MH 或预测治疗反应方面有局限性。一般来说,FCP 在这些方面比 CRP 有更好的能力;此外,富含亮氨酸的α2 糖蛋白可以比 CRP 更好地诊断内镜疾病活动。新型生物标志物,前列腺素 E-主要尿代谢物和抗-αvβ6 抗体有望成为非侵入性和可靠的生物标志物,但需要更多的证据来进行未来的研究。此外,还有其他熟悉和新型的生物标志物,如肿瘤坏死因子 M 和 microRNA。
关键信息:每个生物标志物都有有用的特征;因此,我们应该考虑它们的特征,并在五个作用中使用适当的生物标志物,以实现 IBD 的非侵入性和顺畅管理。
World J Gastroenterol. 2021-4-28
Inflamm Bowel Dis. 2012-2-16
Medicine (Baltimore). 2025-8-8
Curr Gastroenterol Rep. 2025-8-11
Inflammation. 2025-7-18
Front Cell Infect Microbiol. 2025-7-1
J Gastroenterol Hepatol. 2022-5
Front Pharmacol. 2021-7-9
Clin Gastroenterol Hepatol. 2022-5