Folia Biologica
Journal of Cellular and Molecular Biology, Charles University 

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Fol. Biol. 2024, 70, 248-261

https://doi.org/10.14712/fb2024070050248

Serum Biomarkers in Diagnosis and Clinical Management of Inflammatory Bowel Disease: Anything New on the Horizon?

Juraj Ondriš1,2, Rastislav Husťak2,3, Juraj Ďurina4, Eva Malicherová Jurková5, Vladimír Bošák2

1AstraZeneca AB o.z., Bratislava, Slovakia
2Department of Laboratory Medicine, Faculty of Health Care and Social Work, Trnava University, Trnava, Slovakia
3Gastroenterology Department, Clinic of Internal Medicine, University Hospital in Trnava, Slovakia
4Gastroenterology and Hepatology Centre, University Hospital with Polyclinic in Nové Zámky, Slovakia
5Centre for Periodic Fever Syndromes, Department of Paediatrics, Jessenius Faculty of Medicine of Comenius University in Bratislava and University Hospital in Martin, Slovakia

Received August 2024
Accepted January 2025

Persistent inflammation in inflammatory bowel disease (IBD) leads to progressive damage to the gastrointestinal tract, resulting in potentially severe sequelae. Diagnosis primarily relies on invasive endoscopy and monitoring of faecal calprotectin (FC), which has limitations, particularly regarding patient compliance. There is a pressing need for a new biomarker that is non-invasive, easily determinable, and possesses good diagnostic accuracy for both dia­gnosing and monitoring IBD. Our narrative review covers the latest developments in novel serum biomarkers, focusing on those with promising diagnostic accuracy and laboratory methods, and evaluates them in the context of established biomarkers such as FC and CRP. Serum calprotectin (SC) and leucine-rich alpha-2 glycoprotein (LRG) show the most extensive evidence and relatively good diagnostic accuracy but currently cannot replace FC due to insufficient evidence. Major limitations of the analysed studies include their monocentric nature, small sample sizes, lack of longitudinal monitoring and in some cases, missing assessments of endoscopic activity. ELISA holds a leading position among the laboratory methods; however, emerging evidence supports the potential use of point-of-care testing (POCT). Establishing these biomarkers for regular clinical application will require further validation through multicentric studies involving a larger number of patients with a longitudinal design, concurrent assessment of endoscopic activity and pro­active monitoring of the biomarker. However, based on the evidence accumulated so far, SC might potentially serve as a complementary biomarker and/or in assessing the activity of extraintestinal manifestations in IBD patients, while LRG appears to be effective in evaluating endoscopic activity, especially in small bowel CD.

References

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