Treatments for Crohn's Disease-Associated Bowel Damage

A Systematic Review

Benjamin Pariente, Shurong Hu, Dominik Bettenworth, Silvia Speca, Pierre Desreumaux, Marie-Alice Meuwis, Silvio Danese, Florian Rieder, Edouard Louis

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish
JournalClinical Gastroenterology and Hepatology
DOIs
Publication statusE-pub ahead of print - Aug 23 2018

Fingerprint

Crohn Disease
Mesenchymal Stromal Cells
Transforming Growth Factor beta
Fistula
Therapeutics
Fibroblasts
Tissue Inhibitor of Metalloproteinases
Injections
Metalloproteases
Cell- and Tissue-Based Therapy
PubMed
Cell Differentiation
Fibrosis
Stem Cells
Randomized Controlled Trials
Databases
Research
Pharmaceutical Preparations

Cite this

Pariente, B., Hu, S., Bettenworth, D., Speca, S., Desreumaux, P., Meuwis, M-A., ... Louis, E. (2018). Treatments for Crohn's Disease-Associated Bowel Damage: A Systematic Review. Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2018.06.043

Treatments for Crohn's Disease-Associated Bowel Damage : A Systematic Review. / Pariente, Benjamin; Hu, Shurong; Bettenworth, Dominik; Speca, Silvia; Desreumaux, Pierre; Meuwis, Marie-Alice; Danese, Silvio; Rieder, Florian; Louis, Edouard.

In: Clinical Gastroenterology and Hepatology, 23.08.2018.

Research output: Contribution to journalReview article

Pariente, Benjamin ; Hu, Shurong ; Bettenworth, Dominik ; Speca, Silvia ; Desreumaux, Pierre ; Meuwis, Marie-Alice ; Danese, Silvio ; Rieder, Florian ; Louis, Edouard. / Treatments for Crohn's Disease-Associated Bowel Damage : A Systematic Review. In: Clinical Gastroenterology and Hepatology. 2018.
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T2 - A Systematic Review

AU - Pariente, Benjamin

AU - Hu, Shurong

AU - Bettenworth, Dominik

AU - Speca, Silvia

AU - Desreumaux, Pierre

AU - Meuwis, Marie-Alice

AU - Danese, Silvio

AU - Rieder, Florian

AU - Louis, Edouard

N1 - Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

PY - 2018/8/23

Y1 - 2018/8/23

N2 - 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.

AB - 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.

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