Predictive approaches in inflammatory bowel disease

Dear Editors, The authors report the successful development of a mathematical model of inflammatory bowel disease (IBD) structured in two compartments and combining ulcerative colitis (UC) and Crohn’s disease (CD).1 IBDs are multifacets and multiomics diseases.2 Different features contribute to responsiveness to treatments and would need to be carefully considered in parametric predictive models. The immune system presents some plasticity, and one clinical phenotype can activate different inflammatory pathways and respond differently to therapies. As introduced by the authors, UC and CD are two heterogeneous and different diseases, for which immunology is a backbone but not identical.1,3 Their biology is different and leads to different diagnosis, treatment, and monitoring approaches.4 The application of the model to CD therapies is provided.5 Current data suggest that CD is a multiple entity— inflammation is not homogeneous along the colon— and that interleukins pathways and mechanisms of action of potential treatments implicate several tissue layers.1– 3