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Vol. 152. Issue 8.
Pages 310-316 (April 2019)
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Vol. 152. Issue 8.
Pages 310-316 (April 2019)
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DOI: 10.1016/j.medcle.2018.10.018
Use of biomarkers in inflammatory bowel disease
Marcadores de actividad en la enfermedad inflamatoria intestinal
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Juan Egea Valenzuela
Corresponding author
jev1@um.es

Corresponding author.
, Gonzalo Antón Ródenas, Ana Sánchez Martínez
Servicio de Medicina del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
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Table 1. Strategy to be followed in patients who have lost response according to drug levels and the presence or absence of antibodies against it.
Table 2. Other faecal markers for which there is less evidence and in which a specific role has not yet been defined in inflammatory bowel disease.
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Abstract

There are many useful biomarkers for initial diagnosis and the management of inflammatory bowel disease. Serologic biomarkers have been traditionally used because they are widely disposable, but recently faecal biomarkers, especially faecal calprotectin, have acquired great importance as they have shown to be more precise when establishing suspicion of the disease and also as predictors of mucosal healing or persistence of inflammatory activity. Faecal calprotectin is a good tool for predicting abnormal endoscopic studies, but has limited specificity because its levels can be altered in many digestive diseases presenting with similar symptoms. The precision of faecal calprotectin is higher when associated with other altered parameters, especially with C-reactive protein, or with clinical scores of inflammatory activity. Finally, there are many new generation serologic and faecal biomarkers. Despite there not being much evidence about these yet, some of them have shown promising results in different studies.

Keywords:
Inflammatory bowel disease
Crohn's disease
Ulcerative colitis
Biomarkers
Resumen

Existe una gran variedad de marcadores útiles tanto en el diagnóstico como en el seguimiento de la enfermedad inflamatoria intestinal. Clásicamente se han utilizado los serológicos, ampliamente distribuidos y accesibles, pero en los últimos años han cobrado importancia los fecales, en especial la calprotectina fecal, por haber demostrado mayor precisión a la hora tanto de establecer la sospecha de la enfermedad como de predecir la curación mucosa o la persistencia de actividad inflamatoria. La calprotectina fecal muestra buena capacidad para predecir estudios endoscópicos patológicos, pero tiene una especificidad limitada ya que puede alterarse en otros cuadros digestivos con síntomas similares. La calprotectina fecal presenta mayor precisión cuando se asocia a otros parámetros, en especial a la proteína C reactiva, y a escalas clínicas de actividad inflamatoria. Finalmente, hay múltiples marcadores de nueva generación, serológicos y fecales, de los que hay escasa evidencia, aunque algunos han mostrado resultados prometedores en diferentes estudios.

Palabras clave:
Enfermedad inflamatoria intestinal
Enfermedad de Crohn
Colitis ulcerosa
Marcadores

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