Abstract
Cell-free nucleic acids (cfNAs) are defined as any nucleic acids that are present outside the cell. They represent valuable biomarkers in various diagnostic protocols such as prenatal diagnostics, the detection of cancer, and cardiovascular or autoimmune diseases. However, in the current literature, little is known about their implication in inflammatory bowel disease (IBD). IBD is a group of multifactorial, autoimmune, and debilitating diseases with increasing incidence worldwide. Despite extensive research, their etiology and exact pathogenesis is still unclear. Since cfNAs were observed in other autoimmune diseases and appear to be relevant in inflammatory processes, their role in the pathogenesis of IBD has also been suggested. This review provides a summary of knowledge from the available literature about cfDNA and cfRNA and the structures involving them such as exosomes and neutrophil extracellular traps and their association with IBD. Current studies showed the promise of cfNAs in the management of IBD not only as biomarkers distinguishing patients from healthy people and differentiating active from inactive disease state, but also as a potential therapeutic target. However, the detailed biological characteristics of cfNAs need to be fully elucidated in future experimental and clinical studies.
Highlights
Inflammatory bowel disease (IBD), which involves Crohn’s disease (CD) and ulcerative colitis (UC), is a group of multifactorial disorders characterized by chronic inflammation affecting the gastrointestinal tract in variable extent, typically leading to multiple symptoms such as weight loss, abdominal pain, recurrent diarrhea, and bleeding
Anti-neutrophil cytoplasmic autoantibodies (ANCAs) are biomarkers for the diagnosis and prognosis of inflammatory bowel disease (IBD) that are considered to activate, complement, and cause endothelial damage. They are known to target neutrophil proteins, which all are released during Neutrophil extracellular traps (NETs) formation, suggesting this process might be the general cause of ANCAs production in IBD [51]
Different types of Cell-free nucleic acids (cfNAs) can be released to different body fluids by several regulated or unregulated processes under specific physiological and pathophysiological conditions
Summary
Inflammatory bowel disease (IBD), which involves Crohn’s disease (CD) and ulcerative colitis (UC), is a group of multifactorial disorders characterized by chronic inflammation affecting the gastrointestinal tract in variable extent, typically leading to multiple symptoms such as weight loss, abdominal pain, recurrent diarrhea, and bleeding. Current research related to IBD is strongly focused on various aspects of the disease with the aim to elucidate the exact mechanisms of the pathogenesis, as well as to identify either novel biomarkers (for both disease status evaluations, prognostics, and therapeutic response predictions and monitoring) or new therapeutic targets and agents. In a broader context of complex care, the analysis of nuclear genomic material offers the identification of yet asymptomatic individuals having high risk for certain types of IBD [5], while the identification of cfNAs seems to represent promising non-invasive biomarkers to distinguish patients having active disease from those in inactive phase or from healthy people, allowing to track disease onset, progression, and remission following therapy. The aim of this review is to collect and integrate available information about these important aspects
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