Laboratory markers in IBD: useful, magic, or unnecessary toys?
- PMID: 16474109
- PMCID: PMC1856093
- DOI: 10.1136/gut.2005.069476
Laboratory markers in IBD: useful, magic, or unnecessary toys?
Abstract
Laboratory markers have been investigated in inflammatory bowel disease (IBD) for diagnostic and differential diagnostic purposes, for assessment of disease activity and risk of complications, for prediction of relapse, and for monitoring the effect of therapy. The introduction of biological therapies in IBD has renewed interest in inflammatory markers (especially C reactive protein (CRP)), given their potential to select responders to these treatments. Of all the laboratory markers, CRP is the most studied and has been shown to have the best overall performance. CRP is an objective marker of inflammation and correlates well with disease activity in Crohn's disease (CD). Increased CRP levels are associated with better response rates and normal CRP levels predict high placebo response rates in clinical trials with biologicals. However, despite the advantages of CRP over other markers, it is still far from ideal. Furthermore, CRP correlates less well with disease activity in patients with ulcerative colitis (UC) as compared with CD. Other laboratory markers, including erythrocyte sedimentation rate (ESR), leucocyte and platelet count, albumin, and 1 acid glycoprotein (orosomucoid), have been studied either less extensively in IBD or have proven to be less useful than CRP. Faecal markers seem promising and may be more specific in detecting gut inflammation in patients with established IBD. Promising results have been reported with the use of faecal calprotectin in CD as well as in UC. Recent data however suggest that the performance of the faecal calprotectin test is superior for UC than for CD. Taken together, laboratory markers are useful and should be part of the global management of our IBD patients. They are however not magic and until more data become available, the use of CRP and other laboratory markers should be seen as an additive tool to clinical observation and physical examination rather than a replacement.
Conflict of interest statement
Conflict of interest: None declared.
Similar articles
-
Fecal calprotectin and its correlation with inflammatory markers and endoscopy in patients from India with inflammatory bowel disease.Indian J Gastroenterol. 2015 Nov;34(6):431-5. doi: 10.1007/s12664-015-0608-x. Epub 2015 Nov 21. Indian J Gastroenterol. 2015. PMID: 26589229
-
Faecal calprotectin as a novel biomarker for differentiating between inflammatory bowel disease and irritable bowel syndrome.Mol Med Rep. 2014 Jul;10(1):522-6. doi: 10.3892/mmr.2014.2180. Epub 2014 Apr 24. Mol Med Rep. 2014. PMID: 24788223
-
Noninvasive markers in the assessment of intestinal inflammation in inflammatory bowel diseases: performance of fecal lactoferrin, calprotectin, and PMN-elastase, CRP, and clinical indices.Am J Gastroenterol. 2008 Jan;103(1):162-9. doi: 10.1111/j.1572-0241.2007.01556.x. Epub 2007 Oct 4. Am J Gastroenterol. 2008. PMID: 17916108
-
Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation.Health Technol Assess. 2013 Nov;17(55):xv-xix, 1-211. doi: 10.3310/hta17550. Health Technol Assess. 2013. PMID: 24286461 Free PMC article. Review.
-
[Role of biological markers in inflammatory bowel disease].Gastroenterol Hepatol. 2007 Mar;30(3):117-29. doi: 10.1157/13100073. Gastroenterol Hepatol. 2007. PMID: 17374324 Review. Spanish.
Cited by
-
Predictors of Unplanned Health Care Utilization Among Children with Inflammatory Bowel Disease in a Rural Region of the Southeastern US.Dig Dis Sci. 2024 Sep 3. doi: 10.1007/s10620-024-08619-y. Online ahead of print. Dig Dis Sci. 2024. PMID: 39225876
-
C-reactive protein-to-lymphocyte ratio is a novel biomarker for predicting the long-term efficacy of ustekinumab treatment in ulcerative colitis.PLoS One. 2024 Aug 29;19(8):e0305324. doi: 10.1371/journal.pone.0305324. eCollection 2024. PLoS One. 2024. PMID: 39208267 Free PMC article.
-
Microbiota in Mild Inflammatory Bowel Disease (IBD) Can Be Modulated by Beta-Glucans and Mannanoligosaccharides: A Randomized, Double-Blinded Study in Dogs.Vet Sci. 2024 Aug 1;11(8):349. doi: 10.3390/vetsci11080349. Vet Sci. 2024. PMID: 39195803 Free PMC article.
-
Precision Medicine in Inflammatory Bowel Disease: A Spotlight on Emerging Molecular Biomarkers.Biomedicines. 2024 Jul 8;12(7):1520. doi: 10.3390/biomedicines12071520. Biomedicines. 2024. PMID: 39062093 Free PMC article. Review.
-
Use of Biomarkers of Inflammation in the Differentiation of Iron Deficiency and Anaemia-Lessons from Inflammatory Bowel Disease.Diagnostics (Basel). 2024 Jul 13;14(14):1515. doi: 10.3390/diagnostics14141515. Diagnostics (Basel). 2024. PMID: 39061651 Free PMC article.
References
-
- Gabay C, Kushner I. Acute‐phase proteins and other systemic responses to inflammation. N Engl J Med 1999340448–454. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Research Materials
Miscellaneous