Pathogenesis of Fistulating Crohn’s Disease: A Review

McGregor, Colleen GC; Tandon, Ruchi; Simmons, Alison

doi:10.1016/j.jcmgh.2022.09.011

Cited by 12 publications

(9 citation statements)

References 82 publications

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“…In the inflamed tissues of IBD patients, SHH signalling components are overexpressed and in vitro assays have shown that inhibition of epithelial SHH signalling exerts a dual protective effect against inflammation and EMT ( Ghorbaninejad et al, 2022 ). On the other hand, the WNT signalling pathway plays a vital role in homeostasis and repair, and has also been related to intestinal fibrosis ( Lewis et al, 2022 ) and penetrating behaviour in CD ( McGregor et al, 2023 ). In relation to the modulation of intestinal EMT, it has been described that IEC cocultured with IFNγ -treated macrophages ( Macias-Ceja et al, 2022 ) or WNT2b ( Ortiz-Masiá et al, 2020a ) trigger EMT via the FZD4 receptor.…”

Section: Emt Role In Intestinal Fibrosismentioning

confidence: 99%

Role of the epithelial barrier in intestinal fibrosis associated with inflammatory bowel disease: relevance of the epithelial-to mesenchymal transition

Macias-Ceja,

Mendoza-Ballesteros,

Ortega-Albiach

et al. 2023

Front. Cell Dev. Biol.

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In inflammatory bowel disease (IBD), chronic inflammation in the gastrointestinal tract can lead to tissue damage and remodelling, which can ultimately result in fibrosis. Prolonged injury and inflammation can trigger the activation of fibroblasts and extracellular matrix (ECM) components. As fibrosis progresses, the tissue becomes increasingly stiff and less functional, which can lead to complications such as intestinal strictures, obstructive symptoms, and eventually, organ dysfunction. Epithelial cells play a key role in fibrosis, as they secrete cytokines and growth factors that promote fibroblast activation and ECM deposition. Additionally, epithelial cells can undergo a process called epithelial-mesenchymal transition, in which they acquire a more mesenchymal-like phenotype and contribute directly to fibroblast activation and ECM deposition. Overall, the interactions between epithelial cells, immune cells, and fibroblasts play a critical role in the development and progression of fibrosis in IBD. Understanding these complex interactions may provide new targets for therapeutic interventions to prevent or treat fibrosis in IBD. In this review, we have collected and discussed the recent literature highlighting the contribution of epithelial cells to the pathogenesis of the fibrotic complications of IBD, including evidence of EMT, the epigenetic control of the EMT, the potential influence of the intestinal microbiome in EMT, and the possible therapeutic strategies to target EMT. Finally we discuss the pro-fibrotic interactions epithelial-immune cells and epithelial-fibroblasts cells.

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Section: Emt Role In Intestinal Fibrosismentioning

confidence: 99%

Role of the epithelial barrier in intestinal fibrosis associated with inflammatory bowel disease: relevance of the epithelial-to mesenchymal transition

Macias-Ceja,

Mendoza-Ballesteros,

Ortega-Albiach

et al. 2023

Front. Cell Dev. Biol.

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“…Crohn’s disease (CD) is a type of inflammatory bowel disease (IBD) characterized by chronic transmural inflammation of the gastrointestinal tract, which may lead to the formation of fistulas, obstruction, or perforation [ 1 ]. As described by Xu et al, the recognition of CD is increasing as reflected by a rising prevalence in the United States [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Dormant Crohn's Disease Reactivated by Clostridioides difficile Infection

Hernandez¹,

Suarez²,

Nagi³

et al. 2023

Cureus

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Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) characterized by chronic transmural inflammation of any portion of the gastrointestinal tract. The etiology of CD remains unknown although genetic, immunological, and acquired factors have been recognized as contributing to its development. Alterations of intestinal microbiota, including Clostridioides difficile (C. difficile), are theorized to alter humoral immunity and contribute toward CD flare pathogenesis. As such, cases of IBD remission can be undone by alterations in the gut microbiota and subsequently confound the diagnosis of inflammatory or infectious etiologies of diarrhea. We present a case of a 73-year-old female with dormant CD for 25 years who experienced an atypical course of diarrhea found to have a CD flare in the setting of acute C. difficile colitis.

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“…An enterocutaneous fistula (ECF) is an uncommon yet debilitating complication that can arise from a variety of underlying diseases [ 1 ]. Inflammatory bowel diseases (IBDs), most notably Crohn's disease (CD), are among the potential causes of fistula formation with poorly defined pathophysiology [ 2 ]. CD-associated fistula has been shown to arise either in diseased bowels, consistent with the active disease process, or at related surgically created anastomosis sites [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Management of Enterocutaneous Fistula in Crohn’s Disease by Embolization With Glue Injection and Coiling: A Case Report

Shbaita¹,

Daraghmeh²,

Saleem³

et al. 2023

Cureus

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There is one reported case of a pancreatoduodenal fistula that was managed using combined coil embolization and fibrin glue after the failure of other methods. Herein, we document this case to highlight the value of coil embolization and fibrin glue as surgical alternatives for fistula treatment. We present a case of a 39-year-old female patient who has a known case of Crohn’s disease (CD) and presented with an enterocutaneous fistula (ECF) after her most recent surgery. With the failure of conservative approaches and as she refused any surgical interventions, fibrin glue injection and coiling were used. As a conclusion, embolization may work well as a surgical management alternative due to its simplicity.

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Pathogenesis of Fistulating Crohn’s Disease: A Review

Cited by 12 publications

References 82 publications

Role of the epithelial barrier in intestinal fibrosis associated with inflammatory bowel disease: relevance of the epithelial-to mesenchymal transition

Role of the epithelial barrier in intestinal fibrosis associated with inflammatory bowel disease: relevance of the epithelial-to mesenchymal transition

Dormant Crohn's Disease Reactivated by Clostridioides difficile Infection

Management of Enterocutaneous Fistula in Crohn’s Disease by Embolization With Glue Injection and Coiling: A Case Report

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