Location is important: differentiation between ileal and colonic Crohn’s disease

Atreya, Raja; Siegmund, Britta

doi:10.1038/s41575-021-00424-6

Cited by 100 publications

(84 citation statements)

References 198 publications

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“…In addition, because the disease phenotypes themselves manifest differently with, for example, isolated ileal Crohn's disease behaving differently from colonic Crohn's disease, the cascades that should be activated may be different. 25 Ileal disease, for example, manifests with lower inflammatory markers, and pure antiinflammatory agents have shown lower efficacy in this disease. 25 Thereby, agents with higher interagent mechanistic distance or their ability to target complementary pathways within the inflammatory cascade could have a higher chance of success within specific disease phenotypes.…”

Section: Commentariesmentioning

confidence: 99%

“…25 Ileal disease, for example, manifests with lower inflammatory markers, and pure antiinflammatory agents have shown lower efficacy in this disease. 25 Thereby, agents with higher interagent mechanistic distance or their ability to target complementary pathways within the inflammatory cascade could have a higher chance of success within specific disease phenotypes. Additionally, agents targeting immune pathways (immunome) might be combined with those targeting the microbiome or the metabolome.…”

Section: Commentariesmentioning

confidence: 99%

See 1 more Smart Citation

Rational Combination Therapy to Overcome the Plateau of Drug Efficacy in Inflammatory Bowel Disease

Stalgis¹,

Deepak

Mehandru

et al. 2021

Gastroenterology

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Section: Commentariesmentioning

confidence: 99%

Section: Commentariesmentioning

confidence: 99%

Rational Combination Therapy to Overcome the Plateau of Drug Efficacy in Inflammatory Bowel Disease

Stalgis¹,

Deepak

Mehandru

et al. 2021

Gastroenterology

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“…CE can be considered for assessment of disease activity, extent, and phenotype in patients with ECD. Classification of CD by disease location showed that 30% of patients had the ileal type, 40% had the ileocolonic type, and 30% had the colonic type [ 55 ]. The actual rates of ileal and ileocolonic types may be higher if small bowel disease is evaluated by CE in all patients with ECD.…”

Section: Crohn’s Diseasementioning

confidence: 99%

Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

Lim

2021

Diagnostics

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Capsule endoscopy (CE) has proven to be a valuable diagnostic modality for small bowel diseases over the past 20 years, particularly Crohn’s disease (CD), which can affect the entire gastrointestinal tract from the mouth to the anus. CE is not only used for the diagnosis of patients with suspected small bowel CD, but can also be used to assess disease activity, treat-to-target, and postoperative recurrence in patients with established small bowel CD. As CE can detect even mildly non-specific small bowel lesions, a high diagnostic yield is not necessarily indicative of high diagnostic accuracy. Moreover, the cost effectiveness of CE as a third diagnostic test employed usually after ileocolonoscopy and MR or CT enterography is an important consideration. Recently, new developments in colon capsule endoscopy (CCE) have increased the utility of CE in patients with ulcerative colitis (UC) and pan-enteric CD. Although deflation of the colon during the examination and the inability to evaluate dysplasia-associated lesion or mass results in an inherent risk of overestimation or underestimation, the convenience of CCE examination and the risk of flare-up after colonoscopy suggest that CCE could be used more actively in patients with UC.

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“…In this context, disease location appears as a simple way by which patients could be stratified and next beneficiate of better fitted therapy and monitoring. Indeed, ileal and colonic CD present distinct features that might be exploited to better individualise the management of patients 4,5 …”

Section: Introductionmentioning

confidence: 99%

Review article: distinctions between ileal and colonic Crohn's disease: from physiology to pathology

Pierre

Salée

Vieujean

et al. 2021

Aliment Pharmacol Ther

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Summary Background Ileal and colonic Crohn's disease seem to be two separate entities. Aims To describe the main physiological distinctions between the small and the large intestine and to analyse the differences between ileal and colonic Crohn's disease. Methods The relevant literature was critically examined and synthesised. Results The small and large intestine have fundamental distinctions (anatomy, cellular populations, immune defence, microbiota). The differences between ileal and colonic Crohn's disease are highlighted by a heterogeneous body of evidence including clinical features (natural history of the disease, efficacy of treatments, and monitoring), epidemiological data (smoking status, age, gender) and biological data (genetics, microbiota, immunity, mesenteric fat). However, the contribution of these factors to disease location remains poorly understood. Conclusion The classification of ileal and colonic Crohn's disease as distinct subphenotypes is well supported by the literature. Understanding of these differences could be exploited to develop more individualised patient care.

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Location is important: differentiation between ileal and colonic Crohn’s disease

Cited by 100 publications

References 198 publications

Rational Combination Therapy to Overcome the Plateau of Drug Efficacy in Inflammatory Bowel Disease

Rational Combination Therapy to Overcome the Plateau of Drug Efficacy in Inflammatory Bowel Disease

Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

Review article: distinctions between ileal and colonic Crohn's disease: from physiology to pathology

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