Background: Pharmacotranscriptomics aims to reach more accurate drug dosing
based on interindividual transcriptome variations. Here, we provide an overview of RNA biomarkers
that could predict the response to glucocorticoids (GCs), considered the standard for
treatment of inflammatory bowel diseases (IBD), both in adult and pediatric patients. Although
new biological agents are very effective in IBD treatment, GCs are still widely used for induction
of remission in patients with moderate to severe disease. It is important to identify patients
that are poor responders to GCs therapy, because suboptimal response is frequent and associated
with various side effects. A number of genetic variants related to GC mechanism of action
has been studied. However, the majority of reported associations are not consistent. In this regard,
pharmacogenomic research is now exploring the world of RNAs. An appropriate regulation
of the transcriptome, which mainly comprises mRNAs and non-coding RNAs that control
gene expression, has a strong impact in the modulation of GC activity.
Aim: The aim of this review is to present the current knowledge of the role of the transcriptome
in modulating GC response in pediatric IBD.
Results: We will discuss the available literature, concerning the development of pharmacotranscriptomic
biomarkers, focusing particularly on non-coding RNAs, and present the results
in this field that elucidate a concrete benefit of translating the knowledge gained in the "omics"
studies into clinical practice.