title: Biomarkers as a diagnostic tool for irritable bowel syndrome: where are we?
abstract: Irritable bowel syndrome (IBS) is a common condition in clinical practice. There are currently no objective tests to rule in the disease, but rather tests to rule out other diseases. Biomarkers in IBS may provide the tools needed for diagnosis, prognosis and therapy. These include identification of differences in microbial composition, immune activation, bile acid composition, colonic transit, and alteration in sensation in subgroups of IBS patients. Areas covered: Studies included in our review were chosen based on a PubMed search for 'biomarkers' and 'IBS'. We have reviewed the literature on biomarkers to appraise their accuracy, validity and whether they are actionable. We have not covered genetic associations as biomarkers in this review. Expert commentary: There is significant promise in the usefulness of biomarkers for IBS. The most promising actionable biomarkers are markers of changes in bile acid balance, such as elevated bile acid in the stool, and altered colonic transit. However, there is also potential for microbial studies and mucosal proteases as future actionable biomarkers.
authors.affiliation: a Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.) , Mayo Clinic , Rochester , MN, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Camilleri
authors.affiliation: a Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.) , Mayo Clinic , Rochester , MN, USA.
authors.forename: Houssam
authors.initials: H
authors.lastname: Halawi
authors.affiliation: a Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.) , Mayo Clinic , Rochester , MN, USA.
authors.forename: Ibironke
authors.initials: I
authors.lastname: Oduyebo
mesh_terms: D000818:Animals; D001419:Bacteria / Q000378:metabolism*; D001647:Bile Acids and Salts / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D000069196:Gastrointestinal Microbiome; D005769:Gastrointestinal Motility; D006801:Humans; D007422:Intestines / Q000201:enzymology* / Q000382:microbiology / Q000503:physiopathology; D043183:Irritable Bowel Syndrome / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology; D010447:Peptide Hydrolases / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results
chemical_list: D001647:Bile Acids and Salts; D015415:Biomarkers; D010447:Peptide Hydrolases
keywords: Bile acid; chromogranin; enterochromaffin cells; irritable bowel syndrome; lymphocytes; mast cells; microbiome; proteases; scintigraphic transit; visceral sensation