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Novel biomarkers of fibrosis in Crohn’s disease
Authors:Gianluca Pellino  Pierlorenzo Pallante  Francesco Selvaggi
Affiliation:Gianluca Pellino, Francesco Selvaggi, Unit of Colorectal Surgery, Department of Medical, Surgical, Neurological, Metabolic and Ageing Sciences, Second University of Naples, 80138 Naples, ItalyPierlorenzo Pallante, Institute of Experimental Endocrinology and Oncology, National Research Council, c/o Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II” 80131 Naples, Italy
Abstract:Fibrosis represents a major challenge in Crohn’s disease (CD), and many CD patients will develop fibrotic strictures requiring treatment throughout their lifetime. There is no drug that can reverse intestinal fibrosis, and so endoscopic balloon dilatation and surgery are the only effective treatments. Since patients may need repeated treatments, it is important to obtain the diagnosis at an early stage before strictures become symptomatic with extensive fibrosis. Several markers of fibrosis have been proposed, but most need further validation. Biomarkers can be measured either in biological samples obtained from the serum or bowel of CD patients, or using imaging tools and tests. The ideal tool should be easily obtained, cost-effective, and reliable. Even more challenging is fibrosis occurring in ulcerative colitis. Despite the important burden of intestinal fibrosis, including its detrimental effect on outcomes and quality of life in CD patients, it has received less attention than fibrosis occurring in other organs. A common mechanism that acts via a specific signaling pathway could underlie both intestinal fibrosis and cancer. A comprehensive overview of recently introduced biomarkers of fibrosis in CD is presented, along with a discussion of the controversial areas remaining in this field.
Keywords:Crohn’s disease   Fibrosis   Inflammatory bowel diseases   Diagnosis   Biomarkers
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