ArticleBMC gastroenterology2025
Ustekinumab enhances intestinal stenosis resolution by modulating fibrotic pathways in crohn's disease: a retrospective single-center study with translational analysis.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Severity of surgical histopathological fibrosis predicted postoperative recurrence in Crohn's disease: a multi-center retrospective cohort study.Journal of gastroenterology · 2026Article
- Positioning of advanced therapies in patients with moderate-to-severe Crohn's disease.Singapore medical journal · 2026Review
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14 authors.
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Abstract
BACKGROUND AND
aimFew studies have evaluated the impact of biologic therapy on endoscopic findings and stenoses of small intestinal lesions in Crohn's disease (CD). This study aimed to compare the endoscopic effectiveness and stenotic changes induced by anti-tumor necrosis factor inhibitors (anti-TNF) and ustekinumab (UST) in patients with CD, along with histological and molecular comparisons of stenosis between the groups.
methodsWe retrospectively enrolled patients with CD who underwent balloon-assisted enteroscopy before and after initiating anti-TNF therapy or UST. For pathological and molecular evaluation of stenosis, we analyzed resected ileal specimens from patients with CD treated with anti-TNF, UST, or those who were biologic-naïve (bio-naïve).
resultsThe anti-TNF group (n = 18) showed a higher improvement rate in endoscopic activity scores compared to the UST group (n = 19). However, 27.8% of patients in the anti-TNF group experienced worsened stenosis, significantly higher than that in the UST group (0%). Histologically, the UST group showed a lower fibrosis score and reduced collagen III protein expression in the inactive ileum compared to both the anti-TNF and bio-naïve groups. Additionally, the UST group exhibited lower mRNA levels of IL22, TGFB1, and TNF in both active and inactive ilea. Immunostaining revealed fewer α-smooth muscle actin-positive cells in the UST group compared to the anti-TNF and bio-naïve groups in both active and inactive ileum.
conclusionThis study suggests that inhibition of the IL-22/TGF-β pathway by anti-IL-23 treatment with UST may reduce myofibroblasts and improve small intestinal fibrous stenosis in patients with CD.
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