Creeping fat formation and interaction with intestinal disease in Crohn's disease

Abstract

Creeping fat (CrF), also known as fat wrapping, is a significant disease characteristic of Crohn's disease (CD). The transmural inflammation impairs intestinal integrity and facilitates bacteria translocation, aggravating immune response. CrF is a rich source of pro‐inflammatory and pro‐fibrotic cytokines with complex immune microenvironment. The inflamed and stricturing intestine is often wrapped by CrF, and CrF is associated with greater severity of CD. The large amount of innate and adaptive immune cells as well as adipocytes in CrF promote fibrosis in the affected intestine by secreting large amount of pro‐fibrotic cytokines, adipokines, growth factors and fatty acids. CrF is a potential therapeutic target for CD treatment and a promising bio‐marker for predicting response to drug therapy. This review aims to summarize and update the clinical manifestation and application of CrF and the underlying molecular mechanism involved in the pathogenesis of intestinal inflammation and fibrosis in CD.

Association between body fat composition and disease duration, clinical activity, and intravenous corticosteroid-induced response in inflammatory bowel disease

“…Accumulated mesenteric adiposity surrounding the inflamed intestine, also called creeping fat, proactively contributes to the pathogenesis of CD as a characteristic feature [ 41 ]. Proliferated mesenteric adiposity secretes numerous pro-inflammatory substances [ 12 , 42 ], including interleukin‐1β, tumor necrosis factor-α, and interleukin‐6. These substances have long been acknowledged as stimuli of intestinal inflammation [ 42 , 43 ].…”

“…Proliferated mesenteric adiposity secretes numerous pro-inflammatory substances [ 12 , 42 ], including interleukin‐1β, tumor necrosis factor-α, and interleukin‐6. These substances have long been acknowledged as stimuli of intestinal inflammation [ 42 , 43 ]. However, creeping fat also exerts a protective and barrier influence due to overproduced anti-inflammatory cytokines and resident immune cells [ 43 ].…”

Changing paradigms in management of inflammatory bowel disease

“…Increasing evidence suggests a previously unrecognized role of CF in both intestinal inflammation and clinical complications. 14 In this context, Yi et al 15 reviewed the molecular crosstalk between CF and intestinal inflammation, with focus on bacteria translocation and CF formation. Targeting the key mechanism of CF formation may provide relevant data for the development of a novel therapeutic strategy to improve CD outcomes.…”

“…Increasing evidence suggests a previously unrecognized role of CF in both intestinal inflammation and clinical complications 14 . In this context, Yi et al 15 . reviewed the molecular crosstalk between CF and intestinal inflammation, with focus on bacteria translocation and CF formation.…”

CT energy spectral parameters of creeping fat in Crohn’s disease and correlation with inflammatory activity

“…Creeping fat exhibits hyperplasia with increased small round adipocytes, accompanied by vascular proliferation, fibrosis, lymphadenectasis, and stromal cell infiltration [ 8 ]. It is often regarded as an anatomic landmark for the resection of affected bowel segments by surgeons during operation [ 9 – 13 ] and is associated with fibrosis, stricturing complications, and surgical recurrence in CD [ 3 , 5 , 6 , 14 – 16 ].…”