Treatments for Crohn's Disease-Associated Bowel Damage: A Systematic Review.

[en] BACKGROUND & AIMS: Despite significant advances in the treatment of Crohn's disease (CD), most patients still develop stricturing or penetrating complications that require surgical resections. We performed a systematic review of mechanisms and potential treatments for tissue damage lesions in CD patients. METHODS: We searched the PubMed, MBASE, and Cochrane databases from September 2016 through July 2017 for full-length articles on CD, fibrosis, damage lesions, mesenchymal stem cells, and/or treatment. We also searched published conference abstracts and performed manual searches of all reference lists of relevant articles. RESULTS: Mechanisms of intestinal damage in patients with CD include fibroblast proliferation and migration, activation of stellate cells, recruitment of intestinal or extra-intestinal fibroblast, and cell trans-differentiation. An altered balance of metalloproteinases and tissue inhibitors of metalloproteinases might contribute to fistula formation. Treatment approaches that reduce excessive transforming growth factor beta (TGFB) activation might be effective in treating established intestinal damage. Stem cell therapies have been effective in tissue damage lesions in CD. Particularly, randomized controlled trials have shown local injections of mesenchymal stem cells to heal perianal fistulas. CONCLUSION: In a systematic review of mechanisms and treatments of bowel wall damage in patients with CD, we found a need to test drugs that reduce TGFB and increase healing of transmural damage lesions and to pursue research on local injection of mesenchymal stem cells.

Disciplines :

Gastroenterology & hepatology

Author, co-author :

Pariente, Benjamin

Hu, Shurong

Bettenworth, Dominik

Speca, Silvia

Desreumaux, Pierre

Meuwis, Marie-Alice ; Centre Hospitalier Universitaire de Liège - CHU > Service de gastroentérologie, hépatologie, onco. digestive

Danese, Silvio

Rieder, Florian

Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie

Language :

English

Title :

Treatments for Crohn's Disease-Associated Bowel Damage: A Systematic Review.

Publication date :

2019

Journal title :

Clinical Gastroenterology and Hepatology

ISSN :

1542-3565

eISSN :

1542-7714

Publisher :

W. B. Saunders Co., United Kingdom

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.elsevier.com

Commentary :

Available on ORBi :

since 14 April 2019

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