Fibrotic Strictures and Anti-TNF-α Therapy in Crohn’s Disease

Identification of Epithelial to Mesenchymal Transition as a Novel Source of Fibroblasts in Intestinal Fibrosis

“…Additional studies are needed to explore possible synergistic effects of the combination of anti-TNF-␣ therapy and rhBMP-7 in the effective suppression of inflammation and fibrosis in CD. Although controversial, there is some evidence that treatment with infliximab, an anti-TNF-␣ monoclonal antibody, may enhance stricture formation in some patients (44,45). In these patients, dual treatment may be safer and more efficacious.…”

Extracellular Matrix Molecules: Potential Targets in Pharmacotherapy

“…This is true for glucocorticoids and certain other anti-inflammatory and immunomodulatory drugs, such as infliximab, a chimeric monoclonal antibody that blocks the action of tumor necrosis factor-␣ (TNF-␣). Such drugs have been shown to effectively modulate the ECM when used in the treatment of specific fibrotic diseases exhibiting overt inflammation, such as Riedel's thyroiditis and Crohn's disease (Moulik et al, 2004;Sorrentino et al, 2007). The effect of glucocorticoids on the ECM dates back almost 20 years, when it was shown that the inhibitory effect of these drugs was not related to their anti-inflammatory activity (Cutroneo et al, 1990).…”

Role of Biologics and Other Therapies in Stricturing Crohn’s Disease: What Have We Learnt So Far?

“…However, the affected bowel walls remained scarcely distensible and the pre-stenotic dilation, although much reduced, was still present (fig. 6C) [49]. As in the previous cases, infliximab treatment brought about a dramatic resolution of the inflammatory component of the stricture which improved the patient’s conditions.…”

“…Even with the latter, no randomized controlled trial has been conducted and only case or series reports have been published so far [47,48,49,50]. Although initial, open pilot studies have been started [51, 52], additional data would certainly be desirable.…”