Table 1.
Commonly used biomarkers in blood and stool.
| Samples | Biomarkers | Changes in IBD | Advantages | Disadvantages |
|---|---|---|---|---|
| Plasma | CRP (11, 12) | ↑ | 1. Rapid increase in a short period. 2. Sensitive to inflammation 3. The half-life is relatively short (about 19 h). |
1. Lack of specificity 2. Assays vary in their sensitivity and definitions of normal cut-off values 3. Expression of CRP is affected by many factors. |
| ESR (11) | ↑ | Evaluation verification degree. | Low sensitivity and specificity | |
| NLR (13) | ↑ | 1. Used to predict loss of response to IFX in patients with both CD and UC 2. Has utility at nearly every point in IBD management. |
1. Normal range of NLR has not been precisely defined 2. Inconsistent with ESR, FC and CRP in magnitude and significance 3. Impacted by other reasons: age, sex, menopausal status, and so on. |
|
| Stool | Fecal Calprotectin (14–16) | ↑ | 1. High negative predictive value 2. High sensitivity, helps to determine whether an endoscopy is needed, which is cost-effective 3. Good stability (~7 days at room temperature). |
1. Lower specificity of FC for IBD and other inflammatory and infectious conditions 2. disease type (CD vs. UC) and disease location (colitis vs. enteritis) may be associated with distinct levels of FC. |
| Calgranulin C (17–20) | ↑ | 1. Similar diagnostic accuracy to FC 2. Only expressed in neutrophils, thus having better diagnostic performance in IBD 3. Compared with IBD, fecal lactoferrin may be a better predictor of IBS. |
1. Little research on potential applications 2. Poor at predicting or monitoring responses to IBD treatment 3. Weak correlation to clinical and histological severity scores of UC patients. |
|
| Stool lactoferrin (3, 21–23) | ↑ | 1. Strong stability, not affected by multiple freeze-thaw cycles 2. Strong relationship between SL concentration and degree of mucosal inflammation. |
1. Use is mainly limited to research 2. There is a lack of the assessment of responsiveness to disease changes. |
CRP, C-reactive protein; ESR, Erythrocyte sedimentation rate; NLR, Neutrophil–lymphocyte ratio; FC, Fecal Calprotectin; IFX, infliximab; SL, stool lactoferrin; IBS, Irritable bowel syndrome; IBD, Inflammatory bowel disease; UC, ulcerative colitis; CD, Crohn′s disease.