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Molecular Profiling of Inflammatory Bowel Disease: Is It Ready for Use in Clinical Decision-Making?
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Capturing the Biologic Onset of Inflammatory Bowel Diseases: Impact on Translational and Clinical Science

1
IBD Center, Division of Gastroenterology, Virginia Tech Carilion School of Medicine, FRACP 3 Riverside Circle, Roanoke, VA 24016, USA
2
Department of Clinical and Experimental Medical Sciences, University of Udine School of Medicine, 33100 Udine, Italy
*
Author to whom correspondence should be addressed.
Cells 2019, 8(6), 548; https://doi.org/10.3390/cells8060548
Received: 5 May 2019 / Revised: 30 May 2019 / Accepted: 4 June 2019 / Published: 6 June 2019
While much progress has been made in the last two decades in the treatment and the management of inflammatory bowel diseases (IBD)—both ulcerative colitis (UC) and Crohn’s Disease (CD)—as of today these conditions are still diagnosed only after they have become symptomatic. This is a major drawback since by then the inflammatory process has often already caused considerable damage and the disease might have become partially or totally unresponsive to medical therapy. Late diagnosis in IBD is due to the lack of accurate, non-invasive indicators that would allow disease identification during the pre-clinical stage—as it is often done in many other medical conditions. Here, we will discuss what is known about the biologic onset and pre-clinical CD with an emphasis on studies conducted in patients’ first degree relatives. We will then review the possible strategies to diagnose IBD very early in time including screening, available disease markers and imaging, and the possible clinical implications of treating these conditions at or close to their biologic onset. Later, we will review the potential impact of conducting translational research in IBD during the pre-clinical stage, especially focusing on the role of the microbiome in disease etiology and pathogenesis. Finally, we will highlight possible future developments in the field and how they can impact IBD management and our scientific knowledge of these conditions. View Full-Text
Keywords: pre-clinical disease; Crohn’s disease; ulcerative colitis; biologic onset; disease markers; screening; microbiome; early diagnosis pre-clinical disease; Crohn’s disease; ulcerative colitis; biologic onset; disease markers; screening; microbiome; early diagnosis
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Sorrentino, D.; Nguyen, V.Q.; Chitnavis, M.V. Capturing the Biologic Onset of Inflammatory Bowel Diseases: Impact on Translational and Clinical Science. Cells 2019, 8, 548.

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