Published online Aug 15, 2016. doi: 10.4291/wjgp.v7.i3.266
Peer-review started: April 22, 2016
First decision: June 6, 2016
Revised: June 27, 2016
Accepted: July 20, 2016
Article in press: July 22, 2016
Published online: August 15, 2016
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.
Core tip: Fibrosis occurs in a disturbingly large proportion of patients suffering from Crohn’s disease (CD), and invasive procedures may be required for both its diagnosis and treatment. Several biomarkers of intestinal fibrosis have recently been proposed. Most of them still need to be validated, but they could be useful for obtaining an early diagnosis of fibrosis, thereby allowing timely treatment and delaying or even avoiding surgery. 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.