Table 1.
Application | Biomarker | Utility |
Diagnosis of IBD | Fecal calprotectin[69] | Sensitivity: 89%-98%, specificity: 81%-91% |
Fecal lactoferrin[70] | Sensitivity: 80%, specificity: 82% | |
Fecal 100A12[71] (differentiating from IBS) | Sensitivity: 86%, specificity: 96% | |
CRP[72-74] | Sensitivity: Approximately equal 100% in CD, approximately equal 50% in UC poor specificity | |
Distinguishing UC and CD | ASCA[75] | Sensitivity: 40%-50%, specificity: > 90% in CD |
pANCA[75] | Sensitivity: 57%, specificity: 92% | |
Escherichia coli antibodies (Anti-OmpC, Anti-I2, Anti-CBir1)[76] | Sensitivity: 18%-55%, specificity: 76%-93%[76] | |
Marker of disease activity | Fecal lactoferrin[77,78] | Sensitivity: 66%-80% |
Specificity: 60%-100% | ||
Fecal calprotectin[77,78] | Sensitivity: 70%-100% | |
Specificity: 44%-100% | ||
CRP[78] | Sensitivity: 48% | |
Specificity: 91% | ||
Assessing mucosal healing | Fecal calprotectin | Several studies demonstrate significant reduction in biomarker in the presence of mucosal healing with treatment |
Predicting disease course | Fecal lactoferrin[77] | May be associated with complications including; structuring or fistulising disease, and small bowel disease pANCA may predict aggressive UC and pouchitis following surgery[79] |
ASCA | ||
pANCA Anti-I2, Anti-OmpC[12] | ||
Predicting Relapse within 12 mo | Fecal calprotectin[80,81] | Sensitivity: 69%-90% |
Specificity: 69%-82% | ||
Positive predictive value: 81%/87% (UC/CD) | ||
Negative predictive value: 90%/43% (UC/CD) | ||
Fecal lactoferrin[81] | Sensitivity: 62% | |
Specificity: 65% | ||
Predicting therapeutic response | pANCA[82] | Conflicting reports, possible lower response rate to infliximab in patients with a positive serology |
Anti-I2[83] | 94% responded to fecal diversion |
CD: Crohn’s disease; UC: Ulcerative colitis; IBD: Inflammatory bowel disease; ASCA: Anti-Saccharomyces cerevisiae; pANCA: Perinuclear antineutrophil cytoplasmic antibodies; CRP: C-Reactive protein; PF4: Platelet factor 4.