The mesentery in Crohn's disease

Coffey, J. Calvin; O’Leary, Donal Peter; Kiernan, Miranda G.; Faul, P.

doi:10.1097/mog.0000000000000280

Cited by 94 publications

(50 citation statements)

References 81 publications

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“…It has been widely known for decades that mesenteric mesenchymal abnormalities are the hallmarks of CD ( Coffey et al, 2016 ). Although whether mesenteric fat augmentation ( i.e.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, from the results obtained by our co-culture experiments, we postulate that unknown molecules secreted from inflamed IECs also have such a biological impact on adipocyte properties. Researchers have reported that bone marrow-derived fibrocytes, whose quantity is increased in the mesentery in CD, can differentiate into adipocytes ( Coffey et al, 2016 ); therefore, it may be possible that inflamed IECs can secrete factors which can stimulate fibrocytes to undergo adipogenesis. Hence, our co-culture systems would also be useful for identifying candidate factors secreted exclusively from IECs.…”

Section: Discussionmentioning

confidence: 99%

“…The net effects of mesenteric fat abnormalities on CD patients, whether beneficial or harmful, have been debated. Some suggest that the balance of cell types in mesenteric fat abnormalities could exert an immunoprotective effect including M2 macrophage increase, while others stress the pathological effects based on clinical observations ( Coffey et al, 2016 ). Emerging evidence suggests that mesentery including, the mesenteric fat tissues, could be a therapeutic target for CD by both operative and pharmacological means.…”

Section: Introductionmentioning

confidence: 99%

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Reciprocal Inflammatory Signaling Between Intestinal Epithelial Cells and Adipocytes in the Absence of Immune Cells

et al. 2017

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Visceral fat accumulation as observed in Crohn's disease and obesity is linked to chronic gut inflammation, suggesting that accumulation of gut adipocytes can trigger local inflammatory signaling. However, direct interactions between intestinal epithelial cells (IECs) and adipocytes have not been investigated, in part because IEC physiology is difficult to replicate in culture. In this study, we originally prepared intact, polarized, and cytokine responsive IEC monolayers from primary or induced pluripotent stem cell-derived intestinal organoids by simple and repeatable methods. When these physiological IECs were co-cultured with differentiated adipocytes in Transwell, pro-inflammatory genes were induced in both cell types, suggesting reciprocal inflammatory activation in the absence of immunocompetent cells. These inflammatory responses were blocked by nuclear factor-κB or signal transducer and activator of transcription 3 inhibition and by anti-tumor necrosis factor- or anti-interleukin-6-neutralizing antibodies. Our results highlight the utility of these monolayers for investigating IEC biology. Furthermore, this system recapitulates the intestinal epithelium–mesenteric fat signals that potentially trigger or worsen inflammatory disorders such as Crohn's disease and obesity-related enterocolitis.

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“…It has been widely known for decades that mesenteric mesenchymal abnormalities are the hallmarks of CD ( Coffey et al, 2016 ). Although whether mesenteric fat augmentation ( i.e.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reciprocal Inflammatory Signaling Between Intestinal Epithelial Cells and Adipocytes in the Absence of Immune Cells

et al. 2017

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“…There is an increasing focus of research on the role of the mesentery and its role in the recurrence of Crohn's disease. This has been extrapolated to the mesorectum, and there is a suggestion that whilst close rectal dissection may be useful in ulcerative colitis, leaving the mesorectum in Crohn's disease may be deleterious and a TME may be better, although more evidence is awaited .…”

Section: Proctectomy and Proctocolectomymentioning

confidence: 99%

“…There is ongoing interest in the extent of mesenteric resection in surgery for Crohn's disease and some advocate radical resection of inflamed mesentery, on the basis that the mesentery is a driver for ongoing pathology . However, extensive mesenteric dissection is associated with a risk of bleeding and mesenteric haematoma, with may compromise perfusion of the anastomosis.…”

Section: Surgery For Recurrent Ileocaecal Crohn's Diseasementioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

et al. 2018

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Aim There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology. Methods Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. An editorial board was convened to ensure consistency of style, presentation and quality. Each author was asked to provide a set of recommendations which were evidence based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after 2 votes were included in the guidelines. Results All aspects of surgical care for IBD have been included along with 157 recommendations for management. Conclusion These guidelines provide an up to date and evidence based summary of the current surgical knowledge in the management of IBD and will serve as a useful practical text for clinicians performing this type of surgery.

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Perioperative optimization of Crohn's disease

Lin

Chen

et al. 2022

Annals of Gastroent Surgery

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Crohn's disease (CD) is a chronic inflammatory disease mainly affecting the gastrointestinal tract. With the increased availability of modalities in the last two decades, the treatment of CD has advanced remarkably. Although medical treatment is the mainstay of therapy, most patients require surgery during the course of their illness, especially those who experience complications. Nutritional optimization and ERAS implementation are crucial for patients with CD who require surgical intervention to reduce postoperative complications. The increased surgical risk was found to be associated with the use of corticosteroids, but the association of surgical risk with immunomodulators, biologic therapy, such as anti‐TNF mediations, anti‐integrin medications, and anti‐IL 12/23 was low in certainty. Decisions about preoperative medication must be made on an individual case‐dependent basis. Preoperative imaging studies can assist in the planning of appropriate surgical strategies and approaches. However, patients must be informed of any alterations to their treatment. In summary, the management of perioperative medications and surgery‐related decision‐making should be individualized and patient‐centered based on a multidisciplinary approach.

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The mesentery in Crohn's disease

Abstract: http://links.lww.com/COG/A18.

Cited by 94 publications

References 81 publications

Reciprocal Inflammatory Signaling Between Intestinal Epithelial Cells and Adipocytes in the Absence of Immune Cells

Reciprocal Inflammatory Signaling Between Intestinal Epithelial Cells and Adipocytes in the Absence of Immune Cells

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

Perioperative optimization of Crohn's disease

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