P383 The level of intestinal inflammation and fibrosis in resection specimens after preoperative anti-tumour necrosis factor-α treatment in patients with Crohn’s disease: a comparative pilot study
J. Torle1, P. Dabir2, U. Korsgaard3, J.J. Christiansen3, N. Qvist4, A. El-Hussuna5
1Regional Hospital Randers, Surgery, Randers, Denmark, 2Regional Hospital Randers-Denmark, Pathology, Randers, Denmark, 3Regional Hospital Randers, Pathology, Randers, Denmark, 4IBD Care- Surgical Research Unit, Odense University Hospital- Southern University of Denmark, Odense, Denmark, 5Aalborg University Hospital, Surgery, Aalborg, Denmark
Background
Strictures are a common complication in Crohn’s disease (CD), which are found in more than 50% of the patients. They are characterised by excessive deposition of extracellular proteins in the tissue as a result of the chronic inflammatory process. The effect of anti- TNF-α therapy on the development of fibrosis is not yet fully understood. The aim of the study was to investigate whether the degree of intestinal inflammation and fibrosis correlates with pre-operative anti-TNF-α therapy in patients with Crohn’s disease undergoing bowel resection.
Methods
This is an unblinded, prospective, multicentre cohort pilot study. All adult patients with Crohn’s disease, who underwent elective, laparoscopic or open intestinal resection were included. Pre-operative blood investigations included measurement of TNF- α concentration and specific drug antibodies in addition to the concentration of selected inflammatory cytokines. Three pathologists examined the specimens independently and assessed the degree of inflammation and fibrosis.
Results
Histopathological specimens from 10 patients with CD who underwent ileocecal or ileocolic resections were retrieved. Four of those patients were on anti-TNF-α treatment pre-operatively. The last dose of anti-TNF-α agents was administered within 1–9 weeks prior to bowel resection. Patients on anti-TNF-α treatment had higher fibrosis score than the controls (
Conclusion
Patients on anti-TNF-α treatment had higher fibrosis score than the controls.