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Novel bio-genetic predictors of response to biologic treatment in inflammatory bowel diseases.

Authors
  • Mahajna, Hussein1
  • Ben-Horin, Shomron2
  • 1 Gastroenterology Department, Sheba Medical Center, Affiliated to Tel-Aviv University, Tel-Aviv, Israel. Electronic address: [email protected] , (Israel)
  • 2 Gastroenterology Department, Sheba Medical Center, Affiliated to Tel-Aviv University, Tel-Aviv, Israel. , (Israel)
Type
Published Article
Journal
Current opinion in pharmacology
Publication Date
Dec 01, 2020
Volume
55
Pages
132–140
Identifiers
DOI: 10.1016/j.coph.2020.10.011
PMID: 33249396
Source
Medline
Language
English
License
Unknown

Abstract

Despite the evolving therapeutic armamentarium, the treatment of IBD patients remains challenging and many patients fail to respond to biologic agents. With the limited yield of clinical factors to predict the outcome of biologic treatments, studies have focused on identifying genetic alterations and circulating or tissue biomarkers to identify patients who are likely to respond to therapy. In this review, we examine the current knowledge and status of genetic, expression biomarkers, and microbiome predictors. The search for genetic predictors has yielded many genetic loci variants, but few were reproducible. Expression studies of putative biomarkers show promising results, especially with TREM1, oncostatin M and TNF biomarkers, but confirmatory studies are warranted. Finally, the microbiome is emerging as an important player with specific taxa and functional pathways differentially abundant and enriched in responders versus non-responders to certain biologics. Integrating different factors into a robust predictive model, which is both reproducible, accurate and affordable, remains the main challenge before these individualized strategies can reach clinical use. Copyright © 2020 Elsevier Ltd. All rights reserved.

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