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World J Gastrointest Pathophysiol. Feb 15, 2015; 6(1): 13-22
Published online Feb 15, 2015. doi: 10.4291/wjgp.v6.i1.13
Laboratory markers in ulcerative colitis: Current insights and future advances
Michele Cioffi, Antonella De Rosa, Rosalba Serao, Ilaria Picone, Maria Teresa Vietri
Michele Cioffi, Antonella De Rosa, Rosalba Serao, Ilaria Picone, Maria Teresa Vietri, Department of Biochemistry, Biophysics and General Pathology, Second Medical School Naples, 80138 Naples, Italy
Author contributions: Cioffi M designed the research, analysed the data, and wrote the paper; De Rosa A contributed analytic tools, analysed the data; Serao R analysed the data; Picone I contributed analytic tools; Vietri MT designed the research, contributed analytic tools, and wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Michele Cioffi, MD, Department of Biochemistry, Biophysics and General Pathology, Second Medical School Naples, Via L. De Crecchio 7, 80138 Naples, Italy. michele.cioffi@unina2.it
Telephone: +39-08-15665680 Fax: +39-08-1450169
Received: May 27, 2014
Peer-review started: May 27, 2014
First decision: June 28, 2014
Revised: October 3, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: February 15, 2015
Processing time: 260 Days and 1.6 Hours
Abstract

Ulcerative colitis (UC) and Crohn’s disease (CD) are the major forms of inflammatory bowel diseases (IBD) in man. Despite some common features, these forms can be distinguished by different genetic predisposition, risk factors and clinical, endoscopic and histological characteristics. The aetiology of both CD and UC remains unknown, but several evidences suggest that CD and perhaps UC are due to an excessive immune response directed against normal constituents of the intestinal bacterial flora. Tests sometimes invasive are routine for the diagnosis and care of patients with IBD. Diagnosis of UC is based on clinical symptoms combined with radiological and endoscopic investigations. The employment of non-invasive biomarkers is needed. These biomarkers have the potential to avoid invasive diagnostic tests that may result in discomfort and potential complications. The ability to determine the type, severity, prognosis and response to therapy of UC, using biomarkers has long been a goal of clinical researchers. We describe the biomarkers assessed in UC, with special reference to acute-phase proteins and serologic markers and thereafter, we describe the new biological markers and the biological markers could be developed in the future: (1) serum markers of acute phase response: The laboratory tests most used to measure the acute-phase proteins in clinical practice are the serum concentration of C-reactive protein and the erythrocyte sedimentation rate. Other biomarkers of inflammation in UC include platelet count, leukocyte count, and serum albumin and serum orosomucoid concentrations; (2) serologic markers/antibodies: In the last decades serological and immunologic biomarkers have been studied extensively in immunology and have been used in clinical practice to detect specific pathologies. In UC, the presence of these antibodies can aid as surrogate markers for the aberrant host immune response; and (3) future biomarkers: The development of biomarkers in UC will be very important in the future. The progress of molecular biology tools (microarrays, proteomics and nanotechnology) have revolutionised the field of the biomarker discovery. The advances in bioinformatics coupled with cross-disciplinary collaborations have greatly enhanced our ability to retrieve, characterize and analyse large amounts of data generated by the technological advances. The techniques available for biomarkers development are genomics (single nucleotide polymorphism genotyping, pharmacogenetics and gene expression analyses) and proteomics. In the future, the addition of new serological markers will add significant benefit. Correlating serologic markers with genotypes and clinical phenotypes should enhance our understanding of pathophysiology of UC.

Keywords: Inflammatory bowel diseases; Ulcerative colitis; Crohn’s disease; Serologic markers; Acute phase response

Core tip: Ulcerative colitis (UC) and Crohn’s disease are the major forms of inflammatory bowel diseases (IBD). Tests sometimes invasive are routine for the diagnosis and care of patients with IBD. The employment of non-invasive biomarkers is needed. We describe biomarkers assessed in UC, with special reference to acute-phase proteins and serologic markers and thereafter, we describe the new biological markers. The progress of molecular biology tools have revolutionised the field of the biomarker. The techniques available for biomarkers development are genomics and proteomics. Correlating serologic markers with genotypes and clinical phenotypes should enhance our understanding of pathophysiology of UC.