Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2024; 30(46): 4969-4976
Published online Dec 14, 2024. doi: 10.3748/wjg.v30.i46.4969
Gut microbiota and mesenteric adipose tissue interactions in shaping phenotypes and treatment strategies for Crohn’s disease
Anis Hasnaoui, Racem Trigui, Mario Giuffrida
Anis Hasnaoui, Faculty of Medicine of Tunis, Tunis El Manar University, Bab Saadoun Tunis 1007, Tunisia
Anis Hasnaoui, Racem Trigui, Department of General Surgery, Menzel Bourguiba Hospital, Menzel Bourguiba 7050, Bizerte, Tunisia
Mario Giuffrida, Department of General Surgery, Guglielmo da Saliceto Hospital, Piacenza 29100, Italy
Author contributions: Hasnaoui A designed the overall concept, outlined the manuscript, and contributed to the review of the literature and illustration; Trigui R wrote the first draft of the manuscript and contributed to the discussion and design of the manuscript; Giuffrida M contributed to the review of the literature and the revision of the manuscript; All authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anis Hasnaoui, MD, MSc, Assistant Professor, Faculty of Medicine of Tunis, Tunis El Manar University, 15, Djebel Lakhdhar St, Bab Saadoun Tunis 1007, Tunisia. hasnaouianis001@gmail.com
Received: August 30, 2024
Revised: October 3, 2024
Accepted: October 29, 2024
Published online: December 14, 2024
Processing time: 82 Days and 9.5 Hours
Abstract

In this letter, we commented on the article by Wu et al. We examined the interactions between mesenteric adipose tissue, creeping fat, and gut microbiota in Crohn’s disease (CD), a condition marked by chronic gastrointestinal inflammation with a rising global incidence. The pathogenesis of CD involves complex genetic, environmental, and microbial factors. Dysbiosis, which is an imbalance in gut microbial communities, is frequently observed in CD patients, highlighting the pivotal role of the gut microbiota in disease progression and the inflammatory response. Recent studies have shown that mesenteric adipose tissue and creeping fat actively contribute to inflammation by producing proinflammatory cytokines. The relationship between creeping fat and altered microbiota can shift from a potentially protective role to one that encourages bacterial translocation, further complicating disease management. Recent research has suggested that fecal microbiota transplantation could help restore microbial balance, offering a promising therapeutic strategy to improve clinical disease response.

Keywords: Crohn’s disease; Intestinal microbiota; Dysbiosis; Intestinal barrier; Mesenteric adipose tissue; Creeping fat; Fecal microbiota transplantation

Core Tip: The interplay between gut microbiota, mesenteric adipose tissue, and creeping fat is crucial in Crohn’s disease management. Dysbiosis is characterized by decreased beneficial bacteria and increased pathogenic bacteria and exacerbates inflammation and disease progression. Targeting microbial imbalances and the inflammatory roles of mesenteric adipose tissue and creeping fat may lead to novel therapeutic approaches, including fecal microbiota transplantation, which shows promise in restoring microbial balance and achieving sustained remission in patients with Crohn’s disease. Ongoing research should focus on identifying specific microbial communities and their roles in different phenotypes to optimize personalized treatment strategies and improve clinical outcomes.