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Canadian Journal of Gastroenterology
Volume 19, Suppl A, Pages 5A-36A
World Congress of Gastroenterology 2005

Toward an Integrated Clinical, Molecular and Serological Classification of Inflammatory Bowel Disease: Report of a Working Party of the 2005 Montreal World Congress of Gastroenterology

Mark S Silverberg,1 Jack Satsangi,2 Tariq Ahmad,3 Ian DR Arnott,2 Charles N Bernstein,4 Steven R Brant,5 Renzo Caprilli,6 Jean-Frédéric Colombel,7 Christoph Gasche,8 Karel Geboes,9 Derek P Jewell,10 Amir Karban,11 Edward V Loftus Jr,12 A Salvador Peña,13 Robert H Riddell,14 David B Sachar,15 Stefan Schreiber,16 A Hillary Steinhart,1 Stephan R Targan,17 Severine Vermeire,18 and Bryan F Warren19

1Department of Medicine, Mount Sinai Hospital IBD Centre, University of Toronto, Toronto, Ontario, Canada
2Department of Gastroenterology, Western General Hospital, University of Edinburgh, Edinburgh, UK
3Gastroenterology Unit, University of Oxford, Gibson Laboratories, Radcliffe Infirmary, Oxford, UK
4Department of Medicine, Section of Gastroenterology, University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada
5The Harvey M and Lyn P Meyerhoff Inflammatory Bowel Disease Center, Department of Medicine, John Hopkins University School of Medicine, and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
6Department of Clinical Sciences, University of Rome “La Sapienza”, Rome, Italy
7Department of Hepatogastroenterology and Registre EPIMAD, Hôpital HURIEZ, CH et U Lille, France
8Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
9Department of Pathology, University Hospital, Leuven, Belgium
10Department of Gastroenterology, University of Oxford, Oxford, UK
11Department of Gastroenterology, Rambam Medical Center, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
12Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
13Department of Pathology, VU University Medical Centre, Amsterdam, The Netherlands
14Department of Pathology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
15Mount Sinai School of Medicine, New York, USA
16Institute for Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
17Cedars-Sinai Division of Gastroenterology, Inflammatory Bowel Disease Center and Immunobiology Institute, UCLA School of Medicine, Los Angeles, California, USA
18Division of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium
19Department of Cellular Pathology, John Radcliffe Hospital, University of Oxford, Oxford, UK

Copyright © 2005 Canadian Association of Gastroenterology. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (, which permits reuse, distribution, and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


The discovery of a series of genetic and serological markers associated with disease susceptibility and phenotype in inflammatory bowel disease has led to the prospect of an integrated classification system involving clinical, serological and genetic parameters. The Working Party has reviewed current clinical classification systems in Crohn’s disease, ulcerative colitis and indeterminate colitis, and provided recommendations for clinical classification in practice. Progress with respect to integrating serological and genetic markers has been examined in detail, and the implications are discussed. While an integrated system is not proposed for clinical use at present, the introduction of a widely acceptable clinical subclassification is strongly advocated, which would allow detailed correlations among serotype, genotype and clinical phenotype to be examined and confirmed in independent cohorts of patients and, thereby, provide a vital foundation for future work.