The Role of Active Inflammation and Surgical Therapy in Crohn’s Disease Recurrence

An altered balance between effector and regulatory factors is supposed to sustain the tissue-damaging immune response in inflammatory bowel disease (IBD). Several studies demonstrate that severe active inflammation is a strong predictor for surgical complications and recurrence. Indeed, bowel resection in Crohn’s disease (CD) patients has a high surgical recurrence rate. In this review, we examined the IBD inflammatory pathways, the current surgical treatments, and the almost inevitable recurrence. The question that might arise is if the cure of intestinal CD is to be found in the surgical approach. A selective search of two databases (PubMed and the Cochrane Library) has been carried out without considering a specific time horizon as inclusion criteria. The scope of this literature review was investigating on the role of inflammation in the management of CD. The following key words have been used to develop the query string: (i) inflammation; (ii) Crohn’s disease; (iii) surgery; and (iv) postsurgical recurrence.

Download Full-text

A Meta-Analysis of Adalimumab for Fistula in Crohn’s Disease

Gastroenterology Research and Practice ◽

10.1155/2017/1745692 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yin-mei Fu ◽

Ming Chen ◽

Ai-jun Liao

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Controlled Trials ◽

Therapeutic Value ◽

The Cochrane Library

Purpose. This study aimed to evaluate the therapeutic value of adalimumab (ADA) for fistula in Crohn’s disease (CD). Methods. A computerized search of electronic databases, including PubMed, Web of Science, Embase, Google scholar, and the Cochrane Library from 2000 to October 2016, was performed. Randomized controlled trials (rcts) or nonrandomized controlled trials (n-rcts) were included in this article to evaluate the role of ADA in the management of fistula in CD. The methodological index for nonrandomized studies (MINORS evaluation tools) was used to assess the quality of every study. Result. Overall, seven studies and 379 patients comforted to the inclusion criteria of this meta-analysis. The result showed that 36% (95% CI: 0.31–0.41) of patients with complete fistula closure and 31% (95% CI: 0.031–0.61) of patients with partial response were received in CD with ADA treatment. Conclusion. We concluded that ADA is effective and safe for the treatment of fistula in CD according to current evidence.

Download Full-text

The Role of Inflammation in Crohn’s Disease Recurrence after Surgical Treatment

Journal of Immunology Research ◽

10.1155/2020/8846982 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

B. Sensi ◽

L. Siragusa ◽

C. Efrati ◽

L. Petagna ◽

M. Franceschilli ◽

...

Keyword(s):

Crohn’S Disease ◽

Immune System ◽

Crohn's Disease ◽

Disease Recurrence ◽

Postoperative Recurrence ◽

Preventive Strategies ◽

Mesenteric Lymph Nodes ◽

Surgical Strategies ◽

Driving Mechanisms

Introduction. Postoperative recurrence after surgery for Crohn’s disease (CD) is virtually inevitable, and its mechanism is poorly known. Aim. To review the numerous factors involved in CD postoperative recurrence (POR) pathogenesis, focusing on single immune system components as well as the immune system as a whole and highlighting the clinical significance in terms of preventive strategies and future perspectives. Methods. A systematic literature search on CD POR, followed by a review of the main findings. Results. The immune system plays a pivotal role in CD POR, with many different factors involved. Memory T-lymphocytes retained in mesenteric lymph nodes seem to represent the main driving force. New pathophysiology-based preventive strategies in the medical and surgical fields may help reduce POR rates. In particular, surgical strategies have already been developed and are currently under investigation. Conclusions. POR is a complex phenomenon, whose driving mechanisms are gradually being unraveled. New preventive strategies addressing these mechanisms seem promising.

Download Full-text