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Review
. 2020 Dec 16;12(12):504-520.
doi: 10.4253/wjge.v12.i12.504.

Assessment of disease activity in inflammatory bowel diseases: Non-invasive biomarkers and endoscopic scores

Bruno Lima Rodrigues  1 , Márcia Carolina Mazzaro  1 , Cristiane Kibune Nagasako  2 , Maria de Lourdes Setsuko Ayrizono  1 , João José Fagundes  1 , Raquel Franco Leal  3
Affiliations
Review

Assessment of disease activity in inflammatory bowel diseases: Non-invasive biomarkers and endoscopic scores

Bruno Lima Rodrigues et al. World J Gastrointest Endosc. .

Abstract

Inflammatory bowel diseases (IBD) comprise two major forms: Crohn's disease and ulcerative colitis. The diagnosis of IBD is based on clinical symptoms combined with results found in endoscopic and radiological examinations. In addition, the discovery of biomarkers has significantly improved the diagnosis and management of IBD. Several potential genetic, serological, fecal, microbial, histological and immunological biomarkers have been proposed for IBD, and they have been evaluated for clinical routine and clinical trials. Ileocolonoscopy, especially with biopsy collection, has been considered the standard method to diagnose IBD and to assess clinical activity of the disease, but it is limited to the colon and terminal ileum and is considered invasive. For this reason, non-invasive biomarkers are necessary for this type of chronic inflammatory disease, which affects mostly young individuals, as they are expected to have a long follow-up.

Keywords: Biomarkers; Crohn's disease; Endoscopic scores; Inflammation; Inflammatory bowel diseases; Ulcerative colitis.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Endoscopic parameters of lesion evaluation in ulcerative colitis endoscopic scores. A: Total lesion surface area; B: Total ulcer surface area; C: Depth of ulcers.
Figure 2
Figure 2
Ulcerative colitis endoscopic findings. A: Erythema; B: Erosions and granularity; C: Mucopurulent exudate; D: Ulcers.
Figure 3
Figure 3
Prospect of the future usefulness of transcriptional biomarkers in the monitoring of activity and treatment efficacy in patients with inflammatory bowel diseases. OMICS analysis includes transcriptomics, genomics, metabolomics, lipidomics, and epigenomics studies. Fecal biomarkers of disease activity such as calprotectin and lactoferrin are already available in current clinical practice. Moreover, serological exams, such as C-reactive protein, erythrocyte sedimentation rate and platelet count, are commonly used to assess disease activity, despite being nonspecific. IBD: Inflammatory bowel diseases.
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