Ileal and colonic Crohn's disease: Does location makes a difference in therapy efficacy?

Raja Atreya; Christian Bojarski; Anja A Kühl; Zlatko Trajanoski; Markus F Neurath; Britta Siegmund

doi:10.1016/j.crphar.2022.100097

Ileal and colonic Crohn's disease: Does location makes a difference in therapy efficacy?

Curr Res Pharmacol Drug Discov. 2022 Mar 19:3:100097. doi: 10.1016/j.crphar.2022.100097. eCollection 2022.

Authors

Raja Atreya^{1

2

3}, Christian Bojarski⁴, Anja A Kühl^{5

3}, Zlatko Trajanoski^{6

3}, Markus F Neurath^{1

2}, Britta Siegmund⁴

Affiliations

¹ Medical Clinic 1, Department of Medicine, University Hospital Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany.
² Deutsches Zentrum Immuntherapie DZI, Erlangen, Germany.
³ The Transregio 241 IBDome Consortium, Germany.
⁴ Medical Department, Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
⁵ iPATH.Berlin, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
⁶ Biocenter, Institute of Bioinformatics, Medical University Innsbruck, 6020, Innsbruck, Austria.

Abstract

Within the IBD entity of Crohn's disease, there is currently no differentiation between ileal and colonic manifestation for recruitment of patients in clinical trials, well-powered analysis of study results or therapeutic decisions in daily clinical practice. However, there is accumulating evidence from epidemiological, genetic, microbial, immunological, and clinical characteristics that clearly indicate that ileal Crohn's disease represents a distinct disease entity, which differentiates itself from colonic Crohn's disease. This is also reflected by lower efficacy of targeted therapies in isolated ileal compared to colonic Crohn's disease. The distinct site-specific mechanisms that drive heightened non-response in ileal disease need to be analysed in-depth in the future, to enable optimized therapy in the individual Crohn's disease patient.

Keywords: Colonic Crohn's disease; Crohn's disease; Ileal Crohn's disease; Segment; Therapy.

Publication types

Review