The remodeling of extracellular matrix (ECM) within the intestine tissues, which simultaneously involves an increased degradation of ECM components and excessive intestinal
fibrosis, is a defining trait of the progression of
inflammatory bowel diseases (IBDs), which include
ulcerative colitis (UC) and
Crohn's disease (CD). The increased activity of
proteases, especially
matrix metalloproteinases (
MMPs), leads to excessive degradation of the extracellular matrix and the release of
protein and
glycoprotein fragments, previously joined with the extracellular matrix, into the circulation.
MMPs participate in regulating the functions of the epithelial barrier, the immunological response, and the process of wound healing or intestinal
fibrosis. At a later stage of
fibrosis during IBD, excessive formation and deposition of the matrix is observed. To assess changes in the extracellular matrix, quantitative measurement of the concentration in the blood of markers dependent on the activity of
proteases, involved in the breakdown of
extracellular matrix proteins as well as markers indicating the formation of a new ECM, has recently been proposed. This paper describes attempts to use the quantification of ECM components as markers to predict intestinal
fibrosis and evaluate the healing process of the gut. The markers which reflect increased ECM degradation, together with the ones which show the process of creating a new matrix during IBD, allow the attainment of important information regarding the changes in the intestinal tissue, epithelial integrity and extracellular matrix remodeling. This paper contains evidence confirming that ECM remodeling is an integral part of directional cell signaling in the progression of IBD, and not only a basis for the ongoing processes.