The Promise of Single-Cell RNA Sequencing to Redefine the Understanding of Crohn’s Disease Fibrosis Mechanisms
Abstract
:1. Introduction
2. Fibrosis Pathogenesis
3. Current Treatment Strategies
Intervention | Indications | Technical Success Rates | Complications | Recurrence |
---|---|---|---|---|
Endoscopic balloon dilatation | - Short, straight strictures <5 cm - No penetrating complications or deep ulceration - No evidence of malignancy | - >80% (the ability of the endoscope to pass stricture following dilatation) [52] | - 3% perforation risk (increases by 8% for every 1 cm increase in stricture length) [52] | - 52% require repeat dilatation and 30% require surgical intervention at 12 months [50] - 73% require repeat dilatation and 42% require surgery at 24 months [52] |
Endoscopic stricturotomy | - Not yet widely practiced | - >90% immediate technical success rate in retrospective studies [58,59,60] | - Lower perforation rate but higher bleeding rate than balloon dilatation [53] | - Small retrospective studies report a 9–15% subsequent need for surgical intervention [59,60] |
Endoscopic self-expanding metal stent | - Not yet widely practiced | - >90% technical success rate in small retrospective studies - with 60–80% initial symptomatic improvement [61,62] | - Safety profile similar to EBD in one randomised trial; further studies needed [54] | - 49% of patients required further intervention at 12 months in one randomised trial; further studies needed [54] |
Surgical stricturoplasty | - Long strictures to minimise the risk of short bowel - Ileo-colonic anastomotic strictures | NA | - Peri-operative complication rate averages 13% [63] | - Low site-specific recurrence rate (2–5% at 10 years) [55] |
Surgical resection | - Complicated disease with perforation or abscess, or concern regarding malignancy - Localised ileo-caecal disease | NA | - Dependent on multiple factors including the extent of surgery and approach required - Risk of short bowel with multiple/extensive resections | - 25% recurrence rate in a meta-analysis of six studies [64] |
4. Single-Cell Sequencing
5. Spatial Analysis
6. Collaborative Approaches
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Campbell, I.; Glinka, M.; Shaban, F.; Kirkwood, K.J.; Nadalin, F.; Adams, D.; Papatheodorou, I.; Burger, A.; Baldock, R.A.; Arends, M.J.; et al. The Promise of Single-Cell RNA Sequencing to Redefine the Understanding of Crohn’s Disease Fibrosis Mechanisms. J. Clin. Med. 2023, 12, 3884. https://doi.org/10.3390/jcm12123884
Campbell I, Glinka M, Shaban F, Kirkwood KJ, Nadalin F, Adams D, Papatheodorou I, Burger A, Baldock RA, Arends MJ, et al. The Promise of Single-Cell RNA Sequencing to Redefine the Understanding of Crohn’s Disease Fibrosis Mechanisms. Journal of Clinical Medicine. 2023; 12(12):3884. https://doi.org/10.3390/jcm12123884
Chicago/Turabian StyleCampbell, Iona, Michael Glinka, Fadlo Shaban, Kathryn J. Kirkwood, Francesca Nadalin, David Adams, Irene Papatheodorou, Albert Burger, Richard A. Baldock, Mark J. Arends, and et al. 2023. "The Promise of Single-Cell RNA Sequencing to Redefine the Understanding of Crohn’s Disease Fibrosis Mechanisms" Journal of Clinical Medicine 12, no. 12: 3884. https://doi.org/10.3390/jcm12123884
APA StyleCampbell, I., Glinka, M., Shaban, F., Kirkwood, K. J., Nadalin, F., Adams, D., Papatheodorou, I., Burger, A., Baldock, R. A., Arends, M. J., & Din, S. (2023). The Promise of Single-Cell RNA Sequencing to Redefine the Understanding of Crohn’s Disease Fibrosis Mechanisms. Journal of Clinical Medicine, 12(12), 3884. https://doi.org/10.3390/jcm12123884