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World J Gastrointest Pathophysiol. Aug 15, 2016; 7(3): 266-275
Published online Aug 15, 2016. doi: 10.4291/wjgp.v7.i3.266
Novel biomarkers of fibrosis in Crohn’s disease
Gianluca Pellino, Pierlorenzo Pallante, Francesco Selvaggi
Gianluca Pellino, Francesco Selvaggi, Unit of Colorectal Surgery, Department of Medical, Surgical, Neurological, Metabolic and Ageing Sciences, Second University of Naples, 80138 Naples, Italy
Pierlorenzo 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
Author contributions: Pellino G and Pallante P performed research and wrote the paper; Selvaggi F contributed critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: The authors have no conflict of interest to disclose for this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Francesco Selvaggi, MD, EBSQ (Colo.), Associate Professor of General Surgery, Unit of Colorectal Surgery, Department of Medical, Surgical, Neurological, Metabolic and Ageing Sciences, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy. fselvaggi@hotmail.com
Telephone: +39-81-5667919 Fax: +39-81-5667919
Received: April 21, 2016
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
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

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.