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Title: | Precision medicine in inflammatory bowel disease: Concept, progress and challenges. | Authors: | Satsangi J.;Kalla R.;Borg-Bartolo S.P.;Boyapati R.K. | Monash Health Department(s): | Gastroenterology and Hepatology | Institution: | (Borg-Bartolo) Department of Gastroenterology, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT, United Kingdom (Boyapati) Department of Gastroenterology, Monash Health, Clayton, VIC, Australia (Boyapati) Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia (Satsangi) Translational Gastroenterology Unit, Nuffield Department of Medicine, Experimental Medicine Division, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom (Kalla) Department of Gastroenterology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom | Issue Date: | 17-Jun-2020 | Copyright year: | 2020 | Publisher: | F1000 Research Ltd | Place of publication: | United Kingdom | Publication information: | F1000Research. 9 (no pagination), 2020. Article Number: 54. Date of Publication: 2020. | Journal: | F1000 Research | Abstract: | Crohn's disease and ulcerative colitis are increasingly prevalent, relapsing and remitting inflammatory bowel diseases (IBDs) with variable disease courses and complications. Their aetiology remains unclear but current evidence shows an increasingly complex pathophysiology broadly centring on the genome, exposome, microbiome and immunome. Our increased understanding of disease pathogenesis is providing an ever-expanding arsenal of therapeutic options, but these can be expensive and patients can lose response or never respond to certain therapies. Therefore, there is now a growing need to personalise therapies on the basis of the underlying disease biology and a desire to shift our approach from 'reactive' management driven by disease complications to 'proactive' care with an aim to prevent disease sequelae. Precision medicine is the tailoring of medical treatment to the individual patient, encompassing a multitude of data-driven (and multi-omic) approaches to foster accurate clinical decision-making. In IBD, precision medicine would have significant benefits, enabling timely therapy that is both effective and appropriate for the individual. In this review, we summarise some of the key areas of progress towards precision medicine, including predicting disease susceptibility and its course, personalising therapies in IBD and monitoring response to therapy. We also highlight some of the challenges to be overcome in order to deliver this approach.Copyright © 2020 Borg-Bartolo SP et al. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.12688/f1000research.20928.1 | PubMed URL: | 32047622 [http://www.ncbi.nlm.nih.gov/pubmed/?term=32047622] | ISSN: | 2046-1402 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/28871 | Type: | Review | Subjects: | patient care patient monitoring peer review *personalized medicine phenotype prediction relapse remission review treatment response *ulcerative colitis/dt [Drug Therapy] *ulcerative colitis/et [Etiology] tumor necrosis factor antibody/dt [Drug Therapy] disease exacerbation clinical decision making conceptual framework *Crohn disease/dt [Drug Therapy] *Crohn disease/et [Etiology] disease marker disease predisposition disease severity dysbiosis environmental factor genetic risk human immune response inflammatory bowel disease/dt [Drug Therapy] inflammatory bowel disease/et [Etiology] pathogenesis pathophysiology patient care patient monitoring peer personalized medicine phenotype relapse remission ulcerative colitis tumor necrosis factor antibody clinical decision making conceptual framework Crohn disease disease marker disease predisposition dysbiosis environmental factor genetic risk immune response inflammatory bowel disease pathogenesis pathophysiology human immune response inflammatory bowel disease / drug therapy / etiology pathogenesis pathophysiology patient care patient monitoring peer review *personalized medicine phenotype prediction conceptual framework remission Review treatment response *ulcerative colitis / *drug therapy / *etiology clinical decision making relapse *Crohn disease / *drug therapy / *etiology disease exacerbation disease marker disease predisposition disease severity dysbiosis environmental factor genetic risk |
Type of Clinical Study or Trial: | Review article (e.g. literature review, narrative review) |
Appears in Collections: | Articles |
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