Inflammatory bowel disease diagnosis, evaluation and classification: state-of-the art approach.
OBJECTIVE
Progress in inflammatory bowel disease, aided by use of animal models, and focused on pathways leading to inflammation and the relationship between the innate and adaptive immune systems, is identifying target pathogenic mechanisms for therapeutic intervention. This review will describe the most recent advances and discuss promising pathways for therapeutic discovery.


RESULTS
Identification and testing of immune and genetic markers to distinguish subgroups of patients with inflammatory bowel disease have surged over the last decade. What was limited to a few serum antibodies is now complemented with a number of genetic associations. Recent years have seen renewed interest, with additional evidence on the relationship between intestinal commensal bacteria and the inflammatory process in Inflammatory bowel disease.


CONCLUSIONS
There is emerging evidence that discriminating pathogenic abnormalities are present in certain clusters of patients, defined by selected immune responses. These traits have been used to identify correlates between relevant mouse models and immunophenotypic clusters of patients. Such approaches will not only help us to more easily define groups of patients for study, but will also enhance our understanding of the interface between various pathways and disease expression, and ultimately, identify the primal therapeutic targets in the appropriate subgroups of patients.
Targan
Stephan R
SR
Cedars-Sinai Inflammatory Bowel Disease Center, Los Angeles, California 90048, USA. targans@cshs.org
Karp
Loren C
LC
D000818:Animals; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004195:Disease Models, Animal; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000145:classification / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology*; D009154:Mutation; D053473:Nod2 Signaling Adaptor Protein / Q000235:genetics
D001323:Autoantibodies; D015415:Biomarkers; C429018:NOD2 protein, human; D053473:Nod2 Signaling Adaptor Protein