Year 2023 / Volume 115 / Number 6
Editorial
Transmural or mucosal healing in Crohn´s disease. Which is the goal to be pursued?

289-291

DOI: 10.17235/reed.2023.9492/2023

Luis Menchén,

Abstract
In their original report of regional ileitis, Crohn, Ginzburg and Oppenheimer already described that inflammation involved not only the ileal mucosa: “the submucosal and, to a much lesser extent, the muscular layers of the bowel are the seat of marked inflammatory hyperplastic and exudative changes”, they wrote 1. Ninety years later it is well established that the inflammatory process that characterizes Crohn´s disease (CD) involves all the layers of the intestinal wall; this fact is directly related with the development of progressive digestive tract damage related to disabling complications such as strictures, fistulae, perforation, and perianal or abdominal abscesses.
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References
1. Crohn BB, Ginzburg L, Oppenheimer GD. Regional Ileitis - A Pathologic and Clinical Entity. JAMA 1932;99:1323-1329.
2. Cosnes J, Nion-Larmurier I, Beaugerie L, et al. Impact of the increasing use of immunosuppressants in Crohn's disease on the need for intestinal surgery. Gut 2005;54:237-41.
3. Peyrin-Biroulet L, Reinisch W, Colombel JF, et al. Clinical disease activity, C-reactive protein normalisation and mucosal healing in Crohn's disease in the SONIC trial. Gut 2014;63:88-95.
4. Torres J, Bonovas S, Doherty G, et al. ECCO Guidelines on Therapeutics in Crohn's Disease: Medical Treatment. J Crohns Colitis 2020;14:4-22.
5. Shah SC, Colombel JF, Sands BE, et al. Systematic review with meta-analysis: mucosal healing is associated with improved long-term outcomes in Crohn's disease. Aliment Pharmacol Ther 2016;43:317-33.
6. Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis 2019;13:144-164.
7. Puca P, Del Vecchio LE, Ainora ME, et al. Role of Multiparametric Intestinal Ultrasound in the Evaluation of Response to Biologic Therapy in Adults with Crohn's Disease. Diagnostics (Basel) 2022;12.
8. Geyl S, Guillo L, Laurent V, et al. Transmural healing as a therapeutic goal in Crohn's disease: a systematic review. Lancet Gastroenterol Hepatol 2021;6:659-667.
9. Jauregui-Amezaga A, Rimola J, Ordas I, et al. Value of endoscopy and MRI for predicting intestinal surgery in patients with Crohn's disease in the era of biologics. Gut 2015;64:1397-402.
10. Fernandes SR, Rodrigues RV, Bernardo S, et al. Transmural Healing Is Associated with Improved Long-term Outcomes of Patients with Crohn's Disease. Inflamm Bowel Dis 2017;23:1403-1409.
11. Ripolles T, Paredes JM, Martinez-Perez MJ, et al. Ultrasonographic Changes at 12 Weeks of Anti-TNF Drugs Predict 1-year Sonographic Response and Clinical Outcome in Crohn's Disease: A Multicenter Study. Inflamm Bowel Dis 2016;22:2465-73.
12. Castiglione F, Imperatore N, Testa A, et al. One-year clinical outcomes with biologics in Crohn's disease: transmural healing compared with mucosal or no healing. Aliment Pharmacol Ther 2019;49:1026-1039.
13. Ferrante M, Colombel JF, Sandborn WJ, et al. Validation of endoscopic activity scores in patients with Crohn's disease based on a post hoc analysis of data from SONIC. Gastroenterology 2013;145:978-986 e5.
14. Colombel JF, Rutgeerts PJ, Sandborn WJ, et al. Adalimumab induces deep remission in patients with Crohn's disease. Clin Gastroenterol Hepatol 2014;12:414-22 e5.
15. de Voogd F, Bots S, Gecse K, et al. Intestinal Ultrasound Early on in Treatment Follow-up Predicts Endoscopic Response to Anti-TNFalpha Treatment in Crohn's Disease. J Crohns Colitis 2022;16:1598-1608.
16. Messadeg L, Hordonneau C, Bouguen G, et al. Early Transmural Response Assessed Using Magnetic Resonance Imaging Could Predict Sustained Clinical Remission and Prevent Bowel Damage in Patients with Crohn's Disease Treated with Anti-Tumour Necrosis Factor Therapy. J Crohns Colitis 2020;14:1524-1534.
17. Moreno N, Ripolles T, Paredes JM, et al. Usefulness of abdominal ultrasonography in the analysis of endoscopic activity in patients with Crohn's disease: changes following treatment with immunomodulators and/or anti-TNF antibodies. J Crohns Colitis 2014;8:1079-87.
18. Civitelli F, Nuti F, Oliva S, et al. Looking Beyond Mucosal Healing: Effect of Biologic Therapy on Transmural Healing in Pediatric Crohn's Disease. Inflamm Bowel Dis 2016;22:2418-24.
19. Noh SM, Oh EH, Park SH, et al. Association of Faecal Calprotectin Level and Combined Endoscopic and Radiological Healing in Patients With Crohn's Disease Receiving Anti-tumour Necrosis Factor Therapy. J Crohns Colitis 2020;14:1231-1240.
20. Weinstein-Nakar I, Focht G, Church P, et al. Associations Among Mucosal and Transmural Healing and Fecal Level of Calprotectin in Children With Crohn's Disease. Clin Gastroenterol Hepatol 2018;16:1089-1097 e4.
21. Laterza L, Piscaglia AC, Minordi LM, et al. Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn's Disease. Dig Dis 2018;36:184-193.
22. Samuel S, Bruining DH, Loftus EV, Jr., et al. Endoscopic skipping of the distal terminal ileum in Crohn's disease can lead to negative results from ileocolonoscopy. Clin Gastroenterol Hepatol 2012;10:1253-9.
23. Deepak P, Fletcher JG, Fidler JL, et al. Radiological Response Is Associated With Better Long-Term Outcomes and Is a Potential Treatment Target in Patients With Small Bowel Crohn's Disease. Am J Gastroenterol 2016;111:997-1006.
24. Kopylov U, Yung DE, Engel T, et al. Diagnostic yield of capsule endoscopy versus magnetic resonance enterography and small bowel contrast ultrasound in the evaluation of small bowel Crohn's disease: Systematic review and meta-analysis. Dig Liver Dis 2017;49:854-863.
25. Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology 2021;160:1570-1583.
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Menchén L. Transmural or mucosal healing in Crohn´s disease. Which is the goal to be pursued?. 9492/2023


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Publication history

Received: 25/01/2023

Accepted: 14/02/2023

Online First: 22/02/2023

Published: 06/06/2023

Article Online First time: 28 days

Article editing time: 132 days


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