Biomarkers stratify disease phenotype and therapeutic response in inflammatory bowel disease

With recent advances in biological and immunomodulator therapy for inflammatory bowel disease (IBD), there is an increasing need to identify patients with aggressive disease who will benefit from early therapeutic intervention. Serological biomarkers help to determine an immunogenotype that defines disease phenotype and, in conjunction with endoscopic findings, to predict response to therapy. Immunomonitoring responses to biologicals and evaluating trough levels provide additional biomarkers in managing therapy for both primary and secondary non-responders. Genome-wide association studies (GWAS) have revealed numerous susceptibility loci that help define disease phenotype. Emerging work on tissue transcriptional profiling, pharmacogenetic polymorphisms and the human microbiome will guide management of IBD, improve the safety of treatments and allow for individualised therapy.