Do serological markers and cytokines determine the indeterminate?
1Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh School of Medicine, Scaife Hall Room 566, 3550 Terrace Street, Pittsburgh, PA 15261, USA. sep2@pitt.edu
Journal of Clinical Gastroenterology
|April 30, 2004
Summary
Indeterminate colitis (IC) may be a distinct inflammatory bowel disease (IBD) entity. Absence of IBD-associated serologic markers suggests IC is separate from Crohn's disease and ulcerative colitis.
Area of Science:
- Immunogenetics
- Gastroenterology
- Inflammatory Bowel Disease (IBD) Pathogenesis
Background:
- Indeterminate colitis (IC) is often perceived as aggressive and medically refractory.
- IC is associated with increased rates of pouch failure after restorative proctocolectomy.
- The classification of IC remains challenging, with debate on its relation to Crohn's disease (CD) and ulcerative colitis (UC).
Purpose of the Study:
- To discuss the role of serologic markers, genetics, and immune responses in understanding IBD pathogenesis.
- To explore the application of these advances in defining clinically relevant subgroups of IBD patients.
- To review the current understanding of IC within the spectrum of IBD.
Main Methods:
- Review of scientific literature on IBD pathogenesis.
- Analysis of immunogenetic similarities between IC, CD, and UC.
- Examination of serologic markers, genetic factors, and immune responses.
Main Results:
- A recent prospective study indicates that most IC cases lack IBD-associated serologic markers.
- This absence suggests that IC represents a distinct entity within the IBD spectrum.
- Current research aims to differentiate IC from established IBD diagnoses.
Conclusions:
- Serologic, genetic, and immune response markers are crucial for defining IBD subgroups.
- These markers can help redefine the natural history of IBD.
- Development of such markers will enable prediction of therapeutic responses in IBD patients.
