{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:59:00Z","timestamp":1773788340510,"version":"3.50.1"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Clin Transl Gastroenterol","Clinical and Translational Gastroenterology"],"abstract":"<jats:sec>\n            <jats:title>INTRODUCTION:<\/jats:title>\n            <jats:p>In Crohn's disease (CD), the assessment of transmural inflammation and fibrosis is of utmost importance. This study aimed to quantify these parameters in CD ileal specimens and correlate them with disease progression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>This is a retrospective unicentric study based on the analysis of archived specimens (n = 103) of primary ileal resection. Data were retrieved from a prospective national inflammatory bowel disease registry. Two pathologists, blinded for CD phenotype and clinical indications for surgery, examined 3 sections per patient and graded inflammation and fibrosis, based on a histopathological score.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Penetrating (B3, n = 74) CD exhibited significantly higher inflammation in diseased areas, compared with stricturing (B2, n = 29) disease (score 3: 96% vs 76%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.005 in inflamed areas; 78% vs 55%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.019 in most affected areas). This was also observed for the comparison of B2 CD with B3 CD with (B3s, n = 54) and without associated stricture (B3o, n = 20): B3s vs B2: 81% vs 55%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.033 in most affected areas; B3o vs B2: 100% vs 76%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.006 in inflamed areas; 70% vs 55%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.039 in most affected areas. We could not show differences in fibrosis scores between the subphenotypes. Postoperative new penetrating events occurred only in B3s (n = 6, 11%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.043) patients. The changing of biologic therapy after surgery correlated with severe inflammation at the proximal ileal margin (55% changed vs 25% not changed, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.035).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>DISCUSSION:<\/jats:title>\n            <jats:p>In our cohort, fibrosis scores and fibromuscular changes were comparable, irrespective of CD phenotype. Inflammation severity was the major differentiator between penetrating and stricturing disease.\n                                    \n                                       \n                                          \n                                             JOURNAL\/cltg\/04.03\/01720094-202104000-00012\/inline-graphic1\/v\/2023-10-30T212642Z\/r\/image-tiff\n                                          \n                                       \n                                    \n                                 \n                              <\/jats:p>\n          <\/jats:sec>","DOI":"10.14309\/ctg.0000000000000330","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:25:01Z","timestamp":1618359901000},"page":"e00330","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Ileal Crohn's Disease Exhibits Similar Transmural Fibrosis Irrespective of Phenotype"],"prefix":"10.14309","volume":"12","author":[{"given":"Helena","family":"Tavares de Sousa","sequence":"first","affiliation":[{"name":"Gastroenterology Department, Algarve University Hospital Center, Portim\u00e3o, Portugal;"},{"name":"ABC\u2014Algarve Biomedical Center, University of Algarve, Faro, Portugal;"}]},{"given":"Irene","family":"Gullo","sequence":"additional","affiliation":[{"name":"Department of Pathology, S\u00e3o Jo\u00e3o University Hospital Center and Faculty of Medicine, University of Porto, Porto, Portugal;"},{"name":"Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal;"},{"name":"Institute of Investigation and Innovation in Health (i3S), University of Porto, Porto, Portugal;"}]},{"given":"Claudia","family":"Castelli","sequence":"additional","affiliation":[{"name":"Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy;"}]},{"given":"Cl\u00e1udia Camila","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal;"},{"name":"Center for Health Technology and Services Research, University of Porto, Porto, Portugal;"}]},{"given":"Florian","family":"Rieder","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA;"},{"name":"Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA;"}]},{"given":"F\u00e1tima","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Department of Pathology, S\u00e3o Jo\u00e3o University Hospital Center and Faculty of Medicine, University of Porto, Porto, Portugal;"},{"name":"Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal;"},{"name":"Institute of Investigation and Innovation in Health (i3S), University of Porto, Porto, Portugal;"}]},{"given":"Fernando","family":"Magro","sequence":"additional","affiliation":[{"name":"Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Portugal;"},{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital Center, Porto, Portugal;"},{"name":"MedInUP, Center for Drug Discovery and Innovative Medicines, Porto, Portugal."}]}],"member":"276","published-online":{"date-parts":[[2021,4]]},"reference":[{"issue":"10","key":"R1-20241001","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.5858\/2001-125-1331-OMOTSB","article-title":"Obliterative muscularization of the small bowel submucosa in Crohn disease: A possible mechanism of small bowel obstruction","volume":"125","author":"Koukoulis","year":"2001","journal-title":"Arch Pathol Lab 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