Biopsy and blood-based molecular biomarker of inflammation in IBD

Gut. 2023 Jul;72(7):1271-1287. doi: 10.1136/gutjnl-2021-326451. Epub 2022 Sep 15.


Carmen Argmann 1Ruixue Hou 2Ryan C Ungaro 3Haritz Irizar 4Zainab Al-Taie 4 2Ruiqi Huang 2Roman Kosoy 4Swati Venkat 5Won-Min Song 4Antonio F Di'Narzo 4 6Bojan Losic 4Ke Hao 4 6Lauren Peters 4Phillip H Comella 4Gabrielle Wei 4Ashish Atreja 3Milind Mahajan 4 6Alina Iuga 7Prerak T Desai 5Patrick Branigan 5Aleksandar Stojmirovic 5Jacqueline Perrigoue 5Carrie Brodmerkel 5Mark Curran 5Joshua R Friedman 5Amy Hart 5Esi Lamousé-Smith 5Jan Wehkamp 5Saurabh Mehandru 3Eric E Schadt 4 6Bruce E Sands 3Marla C Dubinsky 3Jean-Frederic Colombel 3Andrew Kasarskis 4 6Mayte Suárez-Fariñas 1 2


Author information

1Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA carmen.argmann@mssm.edu mayte.suarezfarinas@mssm.edu.

2Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

3The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

4Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

5Janssen R&D, Spring House, Pennsylvania, USA.

6Sema4, Stamford, Connecticut, USA.

7Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.


Objective: IBD therapies and treatments are evolving to deeper levels of remission. Molecular measures of disease may augment current endpoints including the potential for less invasive assessments.

Design: Transcriptome analysis on 712 endoscopically defined inflamed (Inf) and 1778 non-inflamed (Non-Inf) intestinal biopsies (n=498 Crohn's disease, n=421 UC and 243 controls) in the Mount Sinai Crohn's and Colitis Registry were used to identify genes differentially expressed between Inf and Non-Inf biopsies and to generate a molecular inflammation score (bMIS) via gene set variance analysis. A circulating MIS (cirMIS) score, reflecting intestinal molecular inflammation, was generated using blood transcriptome data. bMIS/cirMIS was validated as indicators of intestinal inflammation in four independent IBD cohorts.

Results: bMIS/cirMIS was strongly associated with clinical, endoscopic and histological disease activity indices. Patients with the same histologic score of inflammation had variable bMIS scores, indicating that bMIS describes a deeper range of inflammation. In available clinical trial data sets, both scores were responsive to IBD treatment. Despite similar baseline endoscopic and histologic activity, UC patients with lower baseline bMIS levels were more likely treatment responders compared with those with higher levels. Finally, among patients with UC in endoscopic and histologic remission, those with lower bMIS levels were less likely to have a disease flare over time.

Conclusion: Transcriptionally based scores provide an alternative objective and deeper quantification of intestinal inflammation, which could augment current clinical assessments used for disease monitoring and have potential for predicting therapeutic response and patients at higher risk of disease flares.

© Copyright 2013-2024 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.