Multigene analysis can discriminate between IBD and IBS

June's issue of Gastroenterology assesses multigene analysis in discriminating between ulcerative colitis, Crohn's, and irritable bowel syndrome.

Inflammatory bowel diseases (IBDs) and the irritable bowel syndrome (IBS) are heterogeneous disorders of the gastrointestinal tract and can profoundly affect the quality of life.

Because many of the symptoms of inflammatory bowel diseases are similar to those of irritable bowel syndrome, the former may be misdiagnosed.

In addition, the 2 major forms of inflammatory bowel diseases, ulcerative colitis and Crohn's disease, have overlapping nonspecific, pathologic features leading to difficulties in assessing colonic inflammation.

The the term Inflammatory bowel diseases unclassified has been proposed.

Dr Petra von Stein and colleagues from Sweden identified and assessed the utility of a certain set of marker genes that could help to distinguish irritable bowel syndrome from inflammatory bowel diseases.

The team also assessed whether the marker genes could discriminate between ulcerative colitis and Crohn's disease.

There are 7 marker genes differentially expressed in inflammatory bowel diseases

Gastroenterology

Subtractive suppression hybridization was used to identify inflammatory bowel diseases-specific genes in colonic mucosal biopsy specimens.

In quantitative polymerase chain reaction experiments, the differential expressions of identified genes then were analyzed using a classification algorithm.

The research team evaluated the possible clinical value of these marker genes in a total of 301 patients in 3 stepwise studies.

The team identified 7 marker genes as differentially expressed in inflammatory bowel diseases.

This made it possible to discriminate between patients suffering from ulcerative colitis, Crohn's disease, or irritable bowel syndrome.

The team found that the area under the receiver-operating characteristic curve was about 0.9 using the clinical diagnosis as gold standard.

Dr von Stein's team commented, "Expression profiling of relevant marker genes in colonic biopsy specimens from patients with inflammatory bowel diseases/irritable bowel syndrome-like symptoms may enable swift and reliable determination of diagnosis, ultimately improving disease management."