Molecular Biomarkers in Inflammatory Bowel Disease: Pathophysiology and New Therapeutic Strategies—3rd Edition

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 240

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Special Issue Information

Dear Colleagues,

Inflammatory bowel disease (IBD) is a comprehensive medical term that represents a spectrum of chronic, idiopathic, and immunologically mediated digestive tract disorders, with the main representatives being Crohn’s disease and ulcerative colitis. Although there are still many unknown factors regarding the etiology and pathophysiology of this disease, it is believed to involve a complex interplay between genetic, epithelial, environmental, microbial, and immunological factors.

Considering that the number of affected patients is increasing worldwide and overall disease management often requires complex and expensive testing, there is a need for convenient, non-invasive, and economical solutions. It is becoming clear that molecular biomarkers are starting to represent a key component in IBD studies, as they can fulfil our requirements and potentially improve numerous areas in IBD management, including timely diagnosis, treatment response, the monitoring of disease activity, and mucosal healing. However, as the current most widely used biomarkers in IBD have certain shortcomings, there is substantial room for improvement and new studies in this field.

Therefore, the main goal of the upcoming Special Issue is to feature the most comprehensive and up-to‑date original research and specialized reviews, helping to encompass and improve knowledge regarding molecular biomarkers that play significant roles in the complex pathophysiological pathways of IBD development, as well as exploring their potential to become new, effective, and reliable tools in disease monitoring, treatment strategies, and precision medicine.

Dr. Marino Vilović
Guest Editor

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Keywords

  • inflammatory bowel disease (IBD)
  • Crohn’s disease
  • ulcerative colitis
  • biomarkers
  • molecular biomarkers in IBD
  • pathophysiology
  • therapeutic approaches in IBD
  • precision medicine

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Published Papers (1 paper)

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Review

24 pages, 1107 KB  
Review
Interpreting Biomarker Discordance in Inflammatory Bowel Disease: Beyond Fecal Calprotectin and C-Reactive Protein
by Lovre Martinovic, Roko Santic, Marko Kumric, Marino Vilovic, Dinko Martinovic and Josko Bozic
Biomedicines 2026, 14(9), 1883; https://doi.org/10.3390/biomedicines14091883 - 24 Aug 2026
Abstract
Treat-to-target management in inflammatory bowel disease (IBD) combines symptoms, fecal and serum biomarkers, endoscopy, histology, and cross-sectional imaging, but these measures frequently diverge. Discordance may reflect analytical variation, timing, disease location, phenotype, comorbidity, or partially non-overlapping biological processes. We performed a critical narrative [...] Read more.
Treat-to-target management in inflammatory bowel disease (IBD) combines symptoms, fecal and serum biomarkers, endoscopy, histology, and cross-sectional imaging, but these measures frequently diverge. Discordance may reflect analytical variation, timing, disease location, phenotype, comorbidity, or partially non-overlapping biological processes. We performed a critical narrative review using a structured PubMed/MEDLINE search, supplemented by citation chaining and publisher searches. Guidelines, systematic reviews, diagnostic studies, cohorts, randomized trials, and selected mechanistic studies were prioritized. Fecal calprotectin (FC) and lactoferrin primarily reflect intestinal neutrophilic inflammation, whereas C-reactive protein (CRP) and related serum indices reflect a nonlocalizing systemic response. The fecal immunochemical test (FIT) detects gastrointestinal bleeding, and leucine-rich alpha-2 glycoprotein (LRG) remains promising but insufficiently standardized. We distinguish five biological biomarker domains—namely, fecal–neutrophil; serum–systemic; epithelial/barrier; restitution/resolution; and fibrosis/extracellular matrix (ECM) remodeling—from symptoms and clinical indices, pharmacologic measurements, and phenotype-directed reference assessments. Circulating barrier, repair, and matrix-turnover markers remain investigational. Reactive therapeutic drug monitoring (TDM) for anti-tumor necrosis factor (anti-TNF) agents has the most mature evidence. Vedolizumab and ustekinumab show exposure–response associations, but actionable thresholds are unvalidated, and clinical TDM is not established for newer biologics or oral small molecules. After objective confirmation of disease activity, the framework may support phenotype-directed therapeutic decisions but is not a validated algorithm. Clinically important disagreement should prompt assessment of sampling, assay, timing, infection, medication-related confounding, and pretest probability before phenotype-directed endoscopy, histology, imaging, or reactive TDM is selected. A single discordant result should neither trigger treatment escalation nor exclude active or structural disease. Full article
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