Advances in non-invasive biomarkers for pediatric inflammatory bowel disease diagnosis.

Pediatric inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), presents significant diagnostic challenges due to its heterogeneous clinical presentation and reliance on invasive procedures such as endoscopy. Recent studies highlight the potential of non-invasive biomarkers, particularly serum cytokines, for distinguishing pediatric IBD from non-IBD conditions. CXCL9, interleukin 8, and interleukin 22 have shown strong discriminatory ability, correlating with disease activity and aiding in the differentiation between CD and UC. These biomarkers may also inform disease progression and treatment needs, including the identification of patients likely to require biologic therapy. However, important gaps remain in translating biomarker findings into routine clinical practice, especially for predicting long-term treatment response. This editorial summarizes recent advances in non-invasive biomarkers for pediatric IBD, focusing on serum, fecal, and genetic markers, and discusses their integration with conventional diagnostic approaches. Ongoing validation in large pediatric cohorts is required to support clinical implementation and optimize biomarker-guided management strategies.