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| 1 | Emerging role of novel biomarkers in the diagnosis of inflammatory bowel disease显示文摘There is currently no gold standard test for the diagnosis of inflammatory bowel disease(IBD). Physicians must rely on a number of diagnostic tools including clinical and endoscopic evaluation as well as histologic, serologic and radiologic assessment. The real difficulty for physicians in both primary and secondary care is differentiating between patients suffering from functional symptoms and those with true underlying IBD. Alongside this, there is always concern regarding the possibility of a missed, or delayed diagnosis of ulcerative colitis(UC) or Crohn's disease. Even once the diagnosis of IBD has been made, there is often uncertainty in distinguishing between cases of UC or Crohn's. As a consequence, in cases of incorrect diagnosis, optimal treatment and management may be adversely affected. Endoscopic evaluation can be uncomfortable and inconvenient for patients. It carries significant risks including perforation and in terms of monetary cost, is expensive. The use of biomarkers to help in the diagnosis and differentiation of IBD has been increasing over time. However, there is not yet one biomarker, which is sensitive of specific enough to be used alone in diagnosing IBD. Current serum testing includes C-reactive protein and erythrocyte sedimentation rate, which are cheap, reliable but non-specific and thus not ideal. Stool based testing such as faecal calprotectin is a much more specific tool and is currently in widespread clinical use. Noninvasive sampling is of the greatest clinical value and with the recent advances in metabolomics, genetics and proteomics, there are now more tools available to develop sensitive and specific biomarkers to diagnose and differentiate between IBD. Many of these new advances are only in early stages of development but show great promise for future clinical use. | Anet A Soubières Andrew Poullis | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，1： | 6 |
| 2 | Novel biomarkers of fibrosis in Crohn's disease显示文摘Fibrosis represents a major challenge in Crohn's disease(CD),and many CD patients will develop fibrotic strictures requiring treatment throughout their lifetime.There is no drug that can reverse intestinal fibrosis,and so endoscopic balloon dilatation and surgery are the only effective treatments.Since patients may need repeated treatments,it is important to obtain the diagnosis at an early stage before strictures become symptomatic with extensive fibrosis.Several markers of fibrosis have been proposed,but most need further validation.Biomarkers can be measured either in biological samples obtained from the serum or bowel of CD patients,or using imaging tools and tests.The ideal tool should be easily obtained,costeffective,and reliable.Even more challenging is fibrosis occurring in ulcerative colitis.Despite the important burden of intestinal fibrosis,including its detrimental effect on outcomes and quality of life in CD patients,it has received less attention than fibrosis occurring in other organs.A common mechanism that acts via a specific signaling pathway could underlie both intestinal fibrosis and cancer.A comprehensive overview of recently introduced biomarkers of fibrosis in CD is presented,along with a discussion of the controversial areas remaining in this field. | Gianluca Pellino Pierlorenzo Pallante Francesco Selvaggi | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，3： | 2 |
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