Ileal Crohn's Disease Exhibits Similar Transmural Fibrosis Irrespective of Phenotype

• Type: Article in International Scientific Journal
• Date: 2021

Authors

de Sousa, HT (Author) Other; Gullo, I (Author) FMUP; Castelli, C (Author) Other; Dias C (Author) FMUP; Rieder, F (Author) Other; Carneiro F (Author) FMUP; Magro, F (Author) Other

Journal

Title: Clinical and Translational Gastroenterology

Vol. 12

ISSN: 2155-384X

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 8 Citations

Scopus - 9 Citations

Other information

Authenticus ID: P-00T-TJ0

DOI: 10.14309/ctg.0000000000000330

Abstract (EN): INTRODUCTION: In Crohn's disease (CD), the assessment of transmural inflammation and fibrosis is of utmost importance. This study aimed to quantify these parameters in CD ileal specimens and correlate them with disease progression. METHODS: This is a retrospective unicentric study based on the analysis of archived specimens (n = 103) of primary ileal resection. Data were retrieved from a prospective national inflammatory bowel disease registry. Two pathologists, blinded for CD phenotype and clinical indications for surgery, examined 3 sections per patient and graded inflammation and fibrosis, based on a histopathological score. RESULTS: Penetrating (B3, n = 74) CD exhibited significantly higher inflammation in diseased areas, compared with stricturing (B2, n = 29) disease (score 3: 96% vs 76%, P = 0.005 in inflamed areas; 78% vs 55%, P = 0.019 in most affected areas). This was also observed for the comparison of B2 CD with B3 CD with (B3s, n = 54) and without associated stricture (B3o, n = 20): B3s vs B2: 81% vs 55%, P = 0.033 in most affected areas; B3o vs B2: 100% vs 76%, P = 0.006 in inflamed areas; 70% vs 55%, P = 0.039 in most affected areas. We could not show differences in fibrosis scores between the subphenotypes. Postoperative new penetrating events occurred only in B3s (n = 6, 11%, P = 0.043) patients. The changing of biologic therapy after surgery correlated with severe inflammation at the proximal ileal margin (55% changed vs 25% not changed, P = 0.035). [GRAPHICS] DISCUSSION: In our cohort, fibrosis scores and fibromuscular changes were comparable, irrespective of CD phenotype. Inflammation severity was the major differentiator between penetrating and stricturing disease.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 11