Biomarkers in search of Precision Medicine in IBD

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 IBD, many important discoveries soon followed, notably the identification of more than 200 genetic susceptibility loci and characterisation of the gut microbiome (1). 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 behaviour; (2) prediction of drug response and adverse effects; (3) identification of subphenotypic mechanisms to facilitate
drug discovery and selection of new treatments in IBD.