Muscular hyperplasia in Crohn's disease strictures: through thick and thin

Am J Physiol Cell Physiol. 2024 Sep 1;327(3):C671-C683. doi: 10.1152/ajpcell.00307.2024. Epub 2024 Jun 24.

Abstract

Fibrostenosing Crohn's disease (CD) represents a challenging clinical condition characterized by the development of symptomatic strictures within the gastrointestinal tract. Despite therapeutic advancements in managing inflammation, the progression of fibrostenotic complications remains a significant concern, often necessitating surgical intervention. Recent investigations have unveiled the pivotal role of smooth muscle cell hyperplasia in driving luminal narrowing and clinical symptomatology. Drawing parallels to analogous inflammatory conditions affecting other organs, such as the airways and blood vessels, sheds light on common underlying mechanisms of muscular hyperplasia. This review synthesizes current evidence to elucidate the mechanisms underlying smooth muscle cell proliferation in CD-associated strictures, offering insights into potential therapeutic targets. By highlighting the emerging significance of muscle thickening as a novel therapeutic target, this review aims to inform future research endeavors and clinical strategies with the goal to mitigate the burden of fibrostenotic complications in CD and other conditions.

Keywords: Crohn’s disease; fibrostenosing; fibrostenosis; proliferative mechanisms; smooth muscle cells.

Publication types

  • Review

MeSH terms

  • Animals
  • Cell Proliferation
  • Constriction, Pathologic
  • Crohn Disease* / complications
  • Crohn Disease* / pathology
  • Fibrosis
  • Humans
  • Hyperplasia* / pathology
  • Muscle, Smooth* / metabolism
  • Muscle, Smooth* / pathology
  • Myocytes, Smooth Muscle / metabolism
  • Myocytes, Smooth Muscle / pathology