Abstract
Crohn's disease (CD) is an inflammatory bowel disease that can involve any region of the gastrointestinal tract. First described in 1932 as terminal ileitis or regional enteritis, it predominately involves the ileum with or without colonic involvement. Isolated colonic CD was first described in 1960 and since then the phenotypic classification of CD has evolved to stratify patients into isolated ileal, ileocolonic, or isolated colonic involvement. In the current review we evaluate the published literature regarding differences in epidemiology, natural history, pathogenesis, response to therapy, and disease monitoring, when stratified by disease location. Based on the available evidence consideration could be given to a new classification for CD, which splits it into ileum dominant (isolated ileal and ileocolonic) and isolated colonic disease. This may allow for a more optimized approach to clinical care and scientific research for CD.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2634-2643 |
| Number of pages | 10 |
| Journal | Clinical Gastroenterology and Hepatology |
| Volume | 17 |
| Issue number | 13 |
| DOIs | |
| State | Published - Dec 2019 |
Funding
Funding Supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health award K23DK117058, the American College of Gastroenterology Junior Faculty Development Award, and the Crohn's and Colitis Foundation Career Development Award (S.S); by the American Gastroenterology Association Research Scholar Award (N.V.C.); by the Crohn's and Colitis Foundation Career Development Award and University of California San Diego KL2 1KL2TR001444 (B.S.B.); by NIDDK RO1 DK108670 (J.R.N.); and by the Wayne and Gladys Valley Foundation, the Chiba University–University of California San Diego Immunology Initiative, and National Institutes of Health AI079145 (P.B.E.). Conflicts of interest These authors disclose the following: Parambir S. Dulai has consulted for Takeda, Janssen, and Prometheus, and has received research support from Takeda, Janssen, Pfizer, AbbVie, Buhlmann, and Polymedco; Siddharth Singh has received research support from AbbVie and Pfizer, and has consulted for Pfizer, AbbVie, Takeda, and AMAG Pharmaceuticals; Niels Vande Casteele has consulted for Boehringer Ingelheim, Takeda, Janssen, Pfizer, Progenity, and Prometheus, and has received research support from R-Biopharm, Takeda, and UCB; John T. Chang has received grant support from Takeda; Jesus Rivera-Nieves has received grant support from Takeda; Lars Eckmann has served as a consultant for Orphagen Pharmaceuticals and has a laboratory service agreement with Takeda California; William J. Sandborn has received research grants from Atlantic Healthcare Limited, Amgen, Genentech, Gilead Sciences, AbbVie, Janssen, Takeda, Lilly, and Celgene/Receptos, has received consulting fees from AbbVie, Allergan, Amgen, Arena Pharmaceuticals, Avexegen Therapeutics, BeiGene, Boehringer Ingelheim, Celgene, Celltrion, Conatus, Cosmo, Escalier Biosciences, Ferring, Forbion, Genentech, Gilead Sciences, Gossamer Bio, Incyte, Janssen, Kyowa Kirin Pharmaceutical Research, Landos Biopharma, Lilly, Oppilan Pharma, Otsuka, Prizer, Precision IBD, Progenity, Prometheus Laboratories, Reistone, Ritter Pharmaceuticals, Robarts Clinical Trials (owned by Health Academic Research Trust), Series Therapeutics, Shire, Sienna Biopharmaceuticals, Sigmoid Biotechnologies, Sterna Biologicals, Sublimity Therapeutics, Takeda, Theravance Biopharma, Tigenix, Tillotts Pharma, UCB Pharma, Ventyx Biosciences, Vimalan Biosciences, Vivelix Pharmaceuticals, and has stock or stock options from BeiGene, Escalier Biosciences, Gossamer Bio, Oppilan Pharma, Precision IBD, Progenity, Ritter Pharmaceuticals, Ventyx Biosciences, and Vimalan Biosciences. The remaining authors disclose no conflicts. Funding Supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health award K23DK117058 , the American College of Gastroenterology Junior Faculty Development Award, and the Crohn's and Colitis Foundation Career Development Award (S.S); by the American Gastroenterology Association Research Scholar Award (N.V.C.); by the Crohn’s and Colitis Foundation Career Development Award and University of California San Diego KL2 1KL2TR001444 (B.S.B.); by NIDDK RO1 DK108670 (J.R.N.); and by the Wayne and Gladys Valley Foundation , the Chiba University –University of California San Diego Immunology Initiative, and National Institutes of Health AI079145 (P.B.E.).
Keywords
- Classification
- Colonic
- Crohn's Disease
- Ileal
ASJC Scopus subject areas
- Gastroenterology
- Hepatology