Although anti-TNF antibodies have been shown to be effective in many CD patients, a relevant subgroup does not respond to this therapy . The underlying molecular mechanisms associated with endoscopic resistance to anti-TNF therapy were determined by Schmitt et al. .
In this study, mucosal and blood cells from 197 CD patients were isolated prior to and during anti-TNF therapy. CD patients responding to anti-TNF therapy displayed a significantly higher expression of TNF receptor 2 (TNFR2) on mucosal T cells than non-responders prior to initiation. However, the expression of IL-23 receptor (IL23R) was not increased. Array analyses of differentiated gene regulation profiles in intestinal biopsies were compared in endoscopic non-responding CD patients and responders during ongoing anti-TNF therapy.
Within the cohort of CD susceptibility genes, there was a significant upregulation of genes that are associated with IL23R-dependent signalling path...
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