The Mesenteric Fat and Intestinal Muscle Interface: Creeping Fat Influencing Stricture Formation in Crohn’s Disease

Mao, Ren; Kurada, Satya; Gordon, Ilyssa O.; Baker, Mark E.; Gandhi, Namita; McDonald, Christine; Coffey, J. Calvin; Rieder, Florian

doi:10.1093/ibd/izy331

Cited by 152 publications

(94 citation statements)

References 47 publications

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“…In addition, the frequency of pericecal hyperechoic regions was higher in the Ye group than in the non-Ye group (p = 0.021). This pericecal hyperechoic region resembled the ''creeping fat'' [8,12] frequently observed in Crohn's disease patients and CRP values and wall thickness of the terminal ileum were higher in the Ye group than in the non-Ye group in this study. We therefore speculated that the echo density of ileal stroma might be enhanced such as creeping fat, because Ye enteritis involves very severe inflammation spreading from the entire ileal wall layer to the surrounding fatty tissue as in Crohn's disease.…”

Section: Discussionsupporting

confidence: 59%

Yersinia enterocolitica enteritis versus other bacterial enteritis in ultrasonic findings: a single-center case control study

Miyata¹,

Jimbo²,

Kyoudo³

et al. 2020

Preprint

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Background: Yersinia enterocolitica (Ye) causes enteritis with mesenteric lymphadenitis and terminal ileitis, and can be difficult to distinguish from acute appendicitis, especially in children. In addition, because detection from stool culture is more difficult for Ye than for other bacteria causing enteritis, the diagnosis of Ye enteritis is not easy. Abdominal ultrasonography is useful for diagnosing bacterial enteritis, including Ye enteritis. This study diagnosed Ye enteritis and other bacterial enteritis by stool culture and compared and analyzed the ultrasonic findings and clinical features in children. The aims of this study are to compare and analyze ultrasonic findings and clinical features in children with Ye enteritis and other bacterial enteritis.Methods: Participants in this retrospective study comprised all 34 bacterial enteritis patients (3-18 years old) treated between 2014 and 2017. Patients were divided into the Yersinia enterocolitica enteritis (Ye) group and other bacterial enteritis (non-Ye) group from whom other pathogens were detected. Ultrasonic findings (including maximum and minimum diameters of ileocecal lymph nodes (C-LNs), mean major/minor axis ratio, wall thickness of the terminal ileum, and presence of a pericecal hyperechoic region) and blood examinations at first visit were compared between two groups. Results: The Ye group included 13 patients and the non-Ye group included 21 patients. Mean C-reactive protein level was higher in the Ye group (5.9±3.0 mg/dL) than in the non-Ye group (2.7±3.4 mg/dL, p = 0.049). No difference in mean maximum diameter of C-LNs was seen between two groups. However, mean C-LN major/minor axis ratio was lower in the Ye group than in the non-Ye group (p = 0.002) and terminal ileal wall thickness value was higher in the Ye group than in the non-Ye group (p = 0.004). Pericecal hyperechoic region was more frequent in the Ye group than in the non-Ye group (p = 0.021). Conclusion: The combination of characteristic ultrasonic findings identified in this study may improve ultrasonic differentiation of Yersinia enterocolitica enteritis and other bacterial enteritis.

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Section: Discussionsupporting

confidence: 59%

Yersinia enterocolitica enteritis versus other bacterial enteritis in ultrasonic findings: a single-center case control study

Miyata¹,

Jimbo²,

Kyoudo³

et al. 2020

Preprint

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“…Creeping fat in CD patients refers to pathologically altered mesenteric fat tissue located around the inflamed parts of the intestine [101]. Furthermore, mWAT actively contributes to the disease severity and may influence the onset of complications [98,[100][101][102][103][104]. In patients with CD, the localization of mucosal ulcerations is most pronounced along the mesenteric attachments, which suggests a causal link between mesenteric adipose tissue and mucosal changes.…”

Section: Mesenteric White Adipose Tissue In CDmentioning

confidence: 99%

Role of Obesity, Mesenteric Adipose Tissue, and Adipokines in Inflammatory Bowel Diseases

et al. 2019

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Inflammatory bowel diseases (IBDs) are a group of disorders which include ulcerative colitis and Crohn’s disease. Obesity is becoming increasingly more common among patients with inflammatory bowel disease and plays a role in the development and course of the disease. This is especially true in the case of Crohn’s disease. The recent results indicate a special role of visceral adipose tissue and particularly mesenteric adipose tissue, also known as “creeping fat”, in pathomechanism, leading to intestinal inflammation. The involvement of altered adipocyte function and the deregulated production of adipokines, such as leptin and adiponectin, has been suggested in pathogenesis of IBD. In this review, we discuss the epidemiology and pathophysiology of obesity in IBD, the influence of a Western diet on the course of Crohn’s disease and colitis in IBD patients and animal’s models, and the potential role of adipokines in these disorders. Since altered body composition, decrease of skeletal muscle mass, and development of pathologically changed mesenteric white adipose tissue are well-known features of IBD and especially of Crohn’s disease, we discuss the possible crosstalk between adipokines and myokines released from skeletal muscle during exercise with moderate or forced intensity. The emerging role of microbiota and the antioxidative and anti-inflammatory enzymes such as intestinal alkaline phosphatase is also discussed, in order to open new avenues for the therapy against intestinal perturbations associated with IBD.

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“…If excessive, this process ultimately leads to accumulation of extracellular matrix molecules such as collagens or fibronectins and increased tissue stiffness. 3 Recently, IL-36 cytokines (IL-36a, IL-36b, and IL-36g) were identified as potent activators of fibroblasts in the pancreas and kidney, making IL-36 and its downstream signaling pathways a potential target for the treatment of inflammation and fibrosis. 4,5 As a member of the IL-1 family, IL-36 transduces signals via binding to a heterodimeric receptor complex composed of IL36R and its co-receptor IL-1R accessory protein (IL-1RAcP).…”

mentioning

confidence: 99%

“…1 For future antifibrotic therapy approaches, it needs to be kept in mind that it is not excessive extracellular matrix deposition, but a thickening of the muscularis propria may be the main cause of luminal narrowing in fibrostenosing CD. 3 In summary, Scheibe et al 11 are to be congratulated on their work given its thorough nature and its translational relevance. Neutralizing antibodies targeting IL-36R are entering phase II trials in moderate to severe ulcerative colitis (EudraCT 2017-004230-28 and NCT03482635).…”

mentioning

confidence: 99%

Cooling Down the Hot Potato: Anti-Interleukin 36 Therapy Prevents and Treats Experimental Intestinal Fibrosis

Mao

Rieder

2019

Gastroenterology

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The Mesenteric Fat and Intestinal Muscle Interface: Creeping Fat Influencing Stricture Formation in Crohn’s Disease

Cited by 152 publications

References 47 publications

Yersinia enterocolitica enteritis versus other bacterial enteritis in ultrasonic findings: a single-center case control study

Yersinia enterocolitica enteritis versus other bacterial enteritis in ultrasonic findings: a single-center case control study

Role of Obesity, Mesenteric Adipose Tissue, and Adipokines in Inflammatory Bowel Diseases

Cooling Down the Hot Potato: Anti-Interleukin 36 Therapy Prevents and Treats Experimental Intestinal Fibrosis

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