Luminally polarized mural and vascular remodeling in ileal strictures of Crohn's disease

Zhang, Xiaofei; Ko, Huaibin M.; Torres, Joana; Panchal, Hinaben J.; Cai, Zhiqiang; Wagner, Mathilde; Sands, Bruce E.; Colombel, Jean–Frédéric; Cho, Judy H.; Taouli, Bachir; Harpaz, Noam

doi:10.1016/j.humpath.2018.03.004

Cited by 17 publications

(17 citation statements)

References 27 publications

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“…Histologically, the strictured wall displays a twofold increase in mural thickness through disproportional changes within each layer ( Figure 1: Normal margin to Stricture). 9 This leads to about six times less compliant wall. 10 Stricture formation is a slow process and only becomes apparent in late stages, which is why antecedent events are hard to study.…”

Section: Histological Characteristics Of Stricturesmentioning

confidence: 99%

“…Typically, the submucosa is most affected (Figure 1: key events -submucosal fibrosis), leading to a 2-3-fold thickening. 9,[11][12][13][14] Significant fibrosis also affects the subserosa 11,13,15,16 ( Figure 1: key events -subserosal fibrosis). In the muscularis mucosae (Figure 1: key events -MM expansion and fibrosis), fibrosis intermingles with distorted smooth muscle bundles.…”

Section: Histological Characteristics Of Stricturesmentioning

confidence: 99%

“…Despite these changes, the increase in smooth muscle outweighs the increase in collagen; quantitatively, expansion of the muscle layers contributes more to the overall increase in thickness. 9,15 For example, Zhang et al reported a 17-fold increase in muscularis mucosae thickness in ileal strictures, which accounted for nearly half of the wall thickening. 9 Chen et al reported a more modest increase in muscularis mucosae and instead highlighted the 2-fold increase in muscularis propria as the most striking finding.…”

Section: Alfredsson and Wickmentioning

confidence: 99%

“…9,15 For example, Zhang et al reported a 17-fold increase in muscularis mucosae thickness in ileal strictures, which accounted for nearly half of the wall thickening. 9 Chen et al reported a more modest increase in muscularis mucosae and instead highlighted the 2-fold increase in muscularis propria as the most striking finding. Interestingly, muscular hyperplasia/hypertrophy in each layer was higher in the ileum, whereas fibrosis in the submucosa and muscularis propria was significantly higher in colonic lesions.…”

Section: Alfredsson and Wickmentioning

confidence: 99%

“…Sometimes, they create a bridge of hyperplastic muscle between the two layers ( Figure 1: key events -fibromuscular infiltration). 15 Other microanatomical features reported in strictured tissue are the remodelling of mucosal-facing vascular walls in the submucosa, which show smooth muscle thickening and collagen deposition 9 (Figure 1: key events -vascular changes). A feature of CD is the so-called creeping fat (also known as mesenteric fat-wrapping) ( Figure 1: key events -creeping fat).…”

Section: Alfredsson and Wickmentioning

confidence: 99%

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Mechanism of fibrosis and stricture formation in Crohn's disease

Alfredsson

Wick

2020

Scand J Immunol

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The information summarized in this review is from a PubMed search for relevant articles by conjoining three main search blocks with the Boolean operator 'AND'. The first block is the disease group itself and contained ('Inflammatory Bowel Diseases' [Mesh] OR 'Crohns' OR 'Crohn's' OR 'IBD' OR 'Inflammatory bowel disease*'). The second block is the disease condition ('Fibrosis'[Mesh] OR 'Constriction, Pathologic'[Mesh] OR 'Stenos*' OR 'Strictur*' OR 'fibrotic' OR 'fibrosis'). The third block concerned the cellular and molecular mechanisms ('Fibroblasts'[Mesh] OR 'Fibroblast*' OR 'Extracellular matrix'[Mesh] OR 'Intestinal Mucosa'[MeSH] OR 'Myofibroblast*' OR 'Macrophages'[Mesh] OR 'Macrophage*' OR 'Monocyte*' OR 'Leucocytes, Mononuclear'[Mesh] OR 'Dendritic

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Section: Histological Characteristics Of Stricturesmentioning

confidence: 99%

Section: Histological Characteristics Of Stricturesmentioning

confidence: 99%

Section: Alfredsson and Wickmentioning

confidence: 99%

Section: Alfredsson and Wickmentioning

confidence: 99%

Section: Alfredsson and Wickmentioning

confidence: 99%

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Mechanism of fibrosis and stricture formation in Crohn's disease

Alfredsson

Wick

2020

Scand J Immunol

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Computed tomography‐based radiomics nomogram using machine learning for predicting 1‐year surgical risk after diagnosis of Crohn's disease

et al. 2023

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Background Identifying patients with aggressive Crohn's disease (CD) threatened by a high risk of early onset surgery is challenging. Purpose We aimed to establish and validate a radiomics nomogram to predict 1‐year surgical risk after the diagnosis of CD, thereby facilitating therapeutic strategies making. Methods Patients with CD who had undergone baseline computed tomography enterography (CTE) examination at diagnosis were recruited and randomly divided into training and test cohorts at a ratio of 7:3. Enteric phase CTE images were obtained. Inflamed segments and mesenteric fat were semiautomatically segmented, followed by feature selection and signature building. A nomogram of radiomics was constructed and validated using a multivariate logistic regression algorithm. Results A total of 268 eligible patients were retrospectively included, 69 of whom underwent surgery 1‐year after diagnosis. A total of 1218 features from inflamed segments and 1218 features from peripheral mesenteric fat were extracted, and reduced to 10 and 15 potential predictors, respectively, to construct two radiomic signatures. By incorporating the radiomics signatures and clinical factors, the radiomics‐clinical nomogram showed favorable calibration and discrimination in the training cohort, with an area under the curve (AUC) of 0.957, which was confirmed in the test set (AUC, 0.898). Decision curve analysis and net reclassification improvement index demonstrated the clinical usefulness of the nomogram. Conclusions We successfully established and validated a CTE‐based radiomic nomogram with both inflamed segment and mesenteric fat simultaneously evaluated to predict 1‐year surgical risk in CD patients, which assisted in clinical decision‐making and individualized management.

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Grossing Techniques of Gastrointestinal Tract Specimens: Benign

Amarapurkar

2022

Surgical Pathology of the Gastrointestinal System

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Luminally polarized mural and vascular remodeling in ileal strictures of Crohn's disease

Cited by 17 publications

References 27 publications

Mechanism of fibrosis and stricture formation in Crohn's disease

Mechanism of fibrosis and stricture formation in Crohn's disease

Computed tomography‐based radiomics nomogram using machine learning for predicting 1‐year surgical risk after diagnosis of Crohn's disease

Grossing Techniques of Gastrointestinal Tract Specimens: Benign

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