The completion of the human genome project in 2003 represented a major scientific landmark, ushering in a new era with hopes and expectations of fresh insights into disease mechanisms and treatments. In inflammatory bowel disease (IBD), many important discoveries soon followed, notably the identification of >200 genetic susceptibility loci and characterization of the gut microbiome. As “big data”, driven by advances in technology, becomes increasingly available and affordable, individuals with IBD and clinicians alike yearn for tangible outcomes from the promise of “precision medicine”—precise diagnosis, monitoring, and treatment. Here, we provide a commentary on the prospects and challenges of precision medicine and biomarkers in IBD. We focus on the three key areas where precision IBD will have the most impact: (1) disease susceptibility, activity, and behavior; (2) prediction of drug response and adverse effects; and (3) identification of subphenotypic mechanisms to facilitate drug discovery and selection of new treatments in IBD.
1MRC Centre for Inflammation Research, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
2Department of Gastroenterology, Monash Health, Clayton, Victoria, Australia
3Gastrointestinal Unit, Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh, UK
Correspondence: Gwo-Tzer Ho, PhD, FRCP, Centre for Genomic and Experimental Medicine, Western General Hospital, GI Unit, University of Edinburgh, Edinburgh EH4 2XU, UK. E-mail: firstname.lastname@example.org
Received 02 March 2016; accepted 02 August 2016
Guarantor of the article: Gwo-tzer Ho, PhD, FRCP.
Specific author contributions: Conceived the original idea and wrote the manuscript: Ray K. Boyapati and Gwo-tzer Ho; performed literature search and contributed to the writing of the manuscript: Ray K. Boyapati; reviewed and contributed further to the writing of the manuscript: Rahul Kalla and Jack Satsangi.
Financial support: Funding received from Medical Research Council (G0701898 for G.-T.H.), Crohn’s and Colitis UK (M16-1 for G.-T.H.), Edinburgh GI Trustees (for R.K.B.), EU FP-7 grants 305676-2 and 305479-2 (R.K.B. and J.S.).
Potential competing interests: None.