Journal Article

Revisiting fibrosis in inflammatory bowel disease: the gut thickens

Lovisa, Sara, Peyrin-Biroulet Laurent, Ungaro Federica, Danese Silvio, Noviello Daniele, D’Alessio Silvia

2022

Overview

Intestinal fibrosis, which is usually the consequence of chronic inflammation, is a common complication of inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. In the past few years, substantial advances have been made in the areas of pathogenesis, diagnosis and management of intestinal fibrosis. Of particular interest have been inflammation-independent mechanisms behind the gut fibrotic process, genetic and environmental risk factors (such as the role of the microbiota), and the generation of new in vitro and in vivo systems to study fibrogenesis in the gut. A huge amount of work has also been done in the area of biomarkers to predict or detect intestinal fibrosis, including novel cross-sectional imaging techniques. In parallel, researchers are embarking on developing and validating clinical trial end points and protocols to test novel antifibrotic agents, although no antifibrotic therapies are currently available. This Review presents the state of the art on the most recently identified pathogenic mechanisms of this serious IBD-related complication, focusing on possible targets of antifibrotic therapies, management strategies, and factors that might predict fibrosis progression or response to treatment.Intestinal fibrosis is an important feature of inflammatory bowel disease (IBD) that remains poorly understood. Here, D’Alessio and Ungaro et al. review the cellular and molecular mechanisms contributing to intestinal fibrosis and discuss future therapeutic strategies for IBD-related fibrosis.

• Publisher: Nature Publishing Group
• Subject: Crohn's disease / Digestive system / Fibrosis / Gastrointestinal tract / Inflammatory bowel disease / Inflammatory bowel diseases / Intestine / Microbiota / Molecular modelling / Risk factors / Ulcerative colitis