Towards a Multimodal Predictive Model in Immune-Mediated Diseases: Integration of Liquid Biopsy, Gut Microbiome, and High-Resolution Ultrasound for Preventive Medicine in Psoriatic Arthritis and Crohn's Disease
DOI:
https://doi.org/10.70577/asce.v5i3.1078Keywords:
predictive model; preventive medicine; liquid biopsy; microbiome; ultrasound; psoriatic arthritis; Crohn's disease; machine learning.Abstract
The fluctuating and episodic nature of psoriatic arthritis (PsA) and Crohn's disease (CD) represents a major therapeutic challenge. The current reactive paradigm, based on response to manifest symptoms, leaves a critical window of intervention unexploited during the preclinical
phase. Objective: To propose an integrated conceptual model combining liquid biopsy (circulating free DNA, cfDNA), gut microbiome analysis, and high-resolution ultrasound (HRUS) for the preclinical prediction of inflammatory flares. Conceptual framework development: We critically review the evidence supporting each pillar of the model: 1) cfDNA as a dynamic reflector of immune activation; 2) gut dysbiosis as a precursor to systemic and local inflammation; 3) HRUS as an objective anatomical validator. We propose a machine learning architecture to integrate these data domains longitudinally. Theoretical validation and roadmap: The model is grounded in shared pathophysiological mechanisms (IL-23/Th17 axis, gut-joint axis) and convergent findings from independent studies. A detailed methodological roadmap for future empirical validation is presented, including longitudinal design, predictive algorithms, and validation criteria. Conclusion: The multimodal integration of liquid biopsy, microbiome, and HRUS represents a conceptual advance toward a paradigm of preventive and personalized medicine in PsA and CD. This theoretical framework provides a clear pathway for translational research aimed at predicting and potentially preventing inflammatory flares before structural damage occurs.
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Copyright (c) 2026 Vanessa Cecilia Iza Sanga, Daniel Eduardo Rodriguez Guevara, Alexa Geovanna Zurita Pèrez, Ana María Burneo Feijoo, Kevin Gabriel Correa Ortiz
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