Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directions

The pathogenesis of inflammatory bowel disease (IBD) is complex and multifactorial. Undertreated disease has substantial individual and societal consequences. Current patient classification and subsequent positioning of IBD therapy are based on crude, readily accessible clinical data. These broad pa...

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Main Authors: Peter R Gibson, Miles P Sparrow, Fan Zhang, Georgina L Hold, Alex Boussioutas, Susan J Connor, Robert D Little, Thisun Jayawardana, Sabrina Koentgen, Mark G Ward
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:eGastroenterology
Online Access:https://egastroenterology.bmj.com/content/2/1/e100006.full
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author Peter R Gibson
Miles P Sparrow
Fan Zhang
Georgina L Hold
Alex Boussioutas
Susan J Connor
Robert D Little
Thisun Jayawardana
Sabrina Koentgen
Mark G Ward
author_facet Peter R Gibson
Miles P Sparrow
Fan Zhang
Georgina L Hold
Alex Boussioutas
Susan J Connor
Robert D Little
Thisun Jayawardana
Sabrina Koentgen
Mark G Ward
author_sort Peter R Gibson
collection DOAJ
description The pathogenesis of inflammatory bowel disease (IBD) is complex and multifactorial. Undertreated disease has substantial individual and societal consequences. Current patient classification and subsequent positioning of IBD therapy are based on crude, readily accessible clinical data. These broad parameters are unlikely to reflect underlying molecular profiles and may account for the observed heterogeneity in treatment response. Precision medicine offers identification and integration of molecular profiles into clinical decision-making. Despite several promising scientific and technological advances, the pathogenesis and targetable molecular drivers of IBD remain incompletely understood. Precision medicine therefore remains aspirational. This comprehensive narrative review describes our current understanding of IBD pathophysiology, highlights preliminary genetic, immunological and microbial predictors of treatment response and outlines the role of ‘big data’ and machine learning in the path towards precision medicine.
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publishDate 2024-02-01
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series eGastroenterology
spelling doaj-art-e7dbfb915d5640beb659756b18fe85722025-08-20T02:39:25ZengBMJ Publishing GroupeGastroenterology2766-01252976-72962024-02-012110.1136/egastro-2023-100006Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directionsPeter R Gibson0Miles P Sparrow1Fan Zhang2Georgina L Hold3Alex Boussioutas4Susan J Connor5Robert D Little6Thisun Jayawardana7Sabrina Koentgen8Mark G Ward92 Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, AustraliaDepartment of Gastroenterology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Pathophysiology, Guizhou Medical University, Guiyang, China3 Microbiome Research Centre, University of New South Wales, Sydney, New South Wales, Australia2 Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, AustraliaDepartment of Gastroenterology, Liverpool Hospital, Sydney, New South Wales, Australia2 Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia3 Microbiome Research Centre, University of New South Wales, Sydney, New South Wales, Australia3 Microbiome Research Centre, University of New South Wales, Sydney, New South Wales, AustraliaDepartment of Gastroenterology, Alfred Hospital, Melbourne, Victoria, AustraliaThe pathogenesis of inflammatory bowel disease (IBD) is complex and multifactorial. Undertreated disease has substantial individual and societal consequences. Current patient classification and subsequent positioning of IBD therapy are based on crude, readily accessible clinical data. These broad parameters are unlikely to reflect underlying molecular profiles and may account for the observed heterogeneity in treatment response. Precision medicine offers identification and integration of molecular profiles into clinical decision-making. Despite several promising scientific and technological advances, the pathogenesis and targetable molecular drivers of IBD remain incompletely understood. Precision medicine therefore remains aspirational. This comprehensive narrative review describes our current understanding of IBD pathophysiology, highlights preliminary genetic, immunological and microbial predictors of treatment response and outlines the role of ‘big data’ and machine learning in the path towards precision medicine.https://egastroenterology.bmj.com/content/2/1/e100006.full
spellingShingle Peter R Gibson
Miles P Sparrow
Fan Zhang
Georgina L Hold
Alex Boussioutas
Susan J Connor
Robert D Little
Thisun Jayawardana
Sabrina Koentgen
Mark G Ward
Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directions
eGastroenterology
title Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directions
title_full Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directions
title_fullStr Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directions
title_full_unstemmed Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directions
title_short Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directions
title_sort pathogenesis and precision medicine for predicting response in inflammatory bowel disease advances and future directions
url https://egastroenterology.bmj.com/content/2/1/e100006.full
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