Use of serum biomarkers in a diagnostic test for irritable bowel syndrome.
BACKGROUND
Currently, no single serum biomarker can reliably differentiate irritable bowel syndrome (IBS) from other functional gastrointestinal disorders or organic diseases of the gastrointestinal tract.


OBJECTIVE
To develop and validate a diagnostic test using serum biomarkers to detect IBS.


METHODS
Ten serum biomarkers were selected from a potential panel of 140 for their ability to differentiate IBS from non-IBS disease in blood samples from patients with IBS, other gastrointestinal disorders and healthy volunteers. A predictive modelling tool was developed to assess patterns and relationships among the 10 serum biomarkers that best differentiated IBS patients from healthy controls and patients with non-IBS gastrointestinal disease. This model was tested in a different cohort of patients and healthy controls (n = 516) to determine the predictive accuracy of differentiating IBS from non-IBS.


RESULTS
The sensitivity and specificity of the 10-biomarker algorithm for differentiating IBS from non-IBS was 50% and 88% respectively. The positive predictive value was 81%, and the negative predictive value was 64% at 50% IBS prevalence in the validation cohort. Overall accuracy was 70%.


CONCLUSIONS
Assessing serum biomarker patterns can differentiate IBS from non-IBS with reasonable sensitivity and specificity. Assessing serum biomarkers in an overall diagnostic strategy may allow earlier diagnosis and treatment for patients with IBS.
Lembo
A J
AJ
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Neri
B
B
Tolley
J
J
Barken
D
D
Carroll
S
S
Pan
H
H
D000209:Acute-Phase Proteins; D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000097:blood; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000097:blood; D012680:Sensitivity and Specificity; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood; D011503:Transglutaminases / Q000097:blood; D055815:Young Adult
D000209:Acute-Phase Proteins; D015415:Biomarkers; D019208:Brain-Derived Neurotrophic Factor; D016207:Cytokines; D007132:Immunoglobulin Isotypes; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D019715:Tissue Inhibitor of Metalloproteinase-1; D011503:Transglutaminases