Harnessing the Power of Precision Medicine and Novel Biomarkers to Treat Crohn’s Disease
Abstract
:1. Introduction
2. Current Diagnostic Approaches and Limitations
3. IBD Has a Complex and Multifactorial Pathogenesis Which Leads to Heterogeneous Disease Phenotypes
3.1. Genomic and Epigenomic Alterations
3.2. IBD Interactome and Exposome
3.3. The IBD Gut Microbiome
3.3.1. The Chronic Dysbiosis Theory
3.3.2. Unique Characteristics of the Gut Microbiota in IBD Patients Can Predict Disease Phenotypes and Responses to Treatment
4. Exploring New Frontiers in IBD Management
4.1. The Rise of Personalized Medicine: A New Era of Healthcare
Personalized vs. Precision Medicine
4.2. The Era of Disease-Modifying Endpoints
The Search for Novel Biomarkers
5. The Implementation of IBD-Associated Biomarkers Can Be Considered across Various Stages of the Disease
5.1. Diagnostic Biomarkers
5.2. Stratification and Prognostication Biomarkers
5.3. ‘Response to Treatment’ Biomarkers
6. Review of Current ‘Cutting-Edge’ Biomarkers in IBD, Consistent with the Origin of the Biomarker
6.1. Patient-Associated (Clinical) Biomarkers
Blood Based Biomarkers
7. Serum Biomarkers Predicting Response to Treatment
7.1. Fecal Biomarkers
7.2. Tissue-Derived Biomarkers
7.2.1. Oncostatin M
7.2.2. Expression of IL13RA2 (mRNA) in Mucosal Biopsies
7.3. Genetic Biomarkers
7.3.1. Genetic Profiling of Biomarkers
7.3.2. HLA-DQA1*05 as a Genetic Predictor of Immunogenicity
7.3.3. Prediction of Safety via Genetic Biomarkers
7.3.4. Prediction of Response to Treatment via Genetic Biomarkers
7.4. The Microbiome as a Potential Biomarker
7.5. Image-Based Biomarkers (Radiomics)
7.6. The Future: Omics-Inspired Biomarkers
Transcriptional Profiling
8. Integrating Biomarkers in Everyday Clinical Practice—Reality or Wishful Thinking
9. Putting the Pieces Together
9.1. Applying Precision Medicine in IBD Care—Uncovering the How, When, and Who
9.2. Summary: Precision Medicine in IBD: The Quest Continues
Funding
Informed Consent Statement
Conflicts of Interest
References
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Dysbiosis | Reduced microbial diversity and increased abundance of certain bacterial species | [30] |
Firmicutes/Bacteroidetes ratio | Increased Firmicutes/Bacteroidetes ratio in IBD patients | [31] |
Bacterial species | Increased abundance of bacterial species, including Escherichiacoli, Enterobacteriaceae, and Fusobacterium, in IBD patients | [31] |
Viruses | Increased abundance of viruses, including bacteriophages, in IBD patients | [32] |
Fungi | Increased abundance of fungi, including Candida, in IBD patients | [32] |
Metabolites | Altered production of metabolites, such as short-chain fatty acids and mucin, in IBD patients | [31] |
Biomarkers | Description | Exemplars | Leading Studies | References |
---|---|---|---|---|
Diagnostic biomarkers | Biomarkers aid in the process of identifying patients at high risk to develop IBD or in early diagnosis of ibd | Genetic mutations, Perinatal exposures, Environmental Exposures Early life microbiome | Meconium Study Gem Project | [10,45,80] |
Stratification and Prognostication Biomarkers | Separates patients into discrete groups early in the course of the disease in an attempt to support treatment decisions. | Oncostatin M (OSM) and OSM receptor NOD-2 OMP-C ASCA\ANCA | The Genome-wide polygenic risk score | [44,49,51,59,60] |
A prognostic blood test derived from a gene-expression signature of CD8 + T cells | PROFILE trial | |||
An ECM-derived signature derived from intestinal biopsies of newly diagnosed pediatric CD patients | The RISK study | |||
‘Predicting response to treatment’ biomarkers | Biomarkers predicting response to treatment, preferably specific to the mode of action, aiding in treatment decisions | OSM and OSM receptors serum concentrations of IL22 Smoking status BMI TREM-I | [60,62,73,74,81] | |
Treatment safety biomarkers | Biomarkers aimed to identify patients at higher risk to develop side effects | TPMT HLA-DQA1*05 | PANTS study | [48,70] |
Treatment response biomarkers | Noninvasive biomarkers aid in evaluating treatment response, thus reducing the need for invasive assessments | Serum CRP Fecal calprotectin Therapeutic drug monitoring Multi-omics data | CALM study | [37,53,75,82,83,84] |
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Kriger-Sharabi, O.A.; Kopylov, U. Harnessing the Power of Precision Medicine and Novel Biomarkers to Treat Crohn’s Disease. J. Clin. Med. 2023, 12, 2696. https://doi.org/10.3390/jcm12072696
Kriger-Sharabi OA, Kopylov U. Harnessing the Power of Precision Medicine and Novel Biomarkers to Treat Crohn’s Disease. Journal of Clinical Medicine. 2023; 12(7):2696. https://doi.org/10.3390/jcm12072696
Chicago/Turabian StyleKriger-Sharabi, Ofra Aviva, and Uri Kopylov. 2023. "Harnessing the Power of Precision Medicine and Novel Biomarkers to Treat Crohn’s Disease" Journal of Clinical Medicine 12, no. 7: 2696. https://doi.org/10.3390/jcm12072696