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Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis
Published on: October 14, 2025
A sonographic lesion index for Crohn's disease helps monitor changes in transmural bowel damage during therapy
Francesca Zorzi1, Elisa Stasi1, Gerolamo Bevivino1
1Gastrointestinal Unit, Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy.
Background & Aims:
Therapeutic antibodies against tumor necrosis factor α (anti-TNF) are effective in patients with Crohn's disease (CD). Mucosal healing is a surrogate marker of efficacy, but little is known about the effects of anti-TNF agents on structural damage in the intestine. Small-intestine contrast ultrasonography (SICUS) is a valuable tool for assessing CD lesions. A new sonographic quantitative index (the sonographic lesion index for CD [SLIC]) was developed to quantify changes in CD lesions detected by SICUS. We explored whether the SLIC can be used to monitor transmural bowel damage in CD patients during anti-TNF therapy.
Methods:
We performed a prospective study of 29 patients with ileal or ileocolonic CD treated with anti-TNF agents; patients underwent SICUS before and after scheduled induction and maintenance therapy. To determine whether changes that can be detected by SICUS occur independently of anti-TNF therapy, 7 patients with ileal CD treated with mesalamine were enrolled as controls. A clinical response was defined as steroid-free remission, with CD activity index scores less than 150.
Results:
We observed significant improvements in SLIC scores and subscores after induction and maintenance therapy with anti-TNFs, compared with before therapy. SLIC scores and subscores and index classes were improved significantly in patients with vs without clinical responses. Controls had no improvements in terms of CD activity index or SLIC scores, or index classes.
Conclusions:
Sonographic assessment using the quantitative index SLIC can be used to monitor changes in transmural bowel damage during anti-TNF therapy for CD.
Insights
The sonographic lesion index for CD (SLIC) effectively monitors transmural bowel damage in Crohn's disease patients receiving anti-tumor necrosis factor α (anti-TNF) therapy, showing significant improvements with treatment.
Area of Science:
- Gastroenterology
- Medical Imaging
- Pharmacology
Background:
- Therapeutic antibodies targeting tumor necrosis factor α (anti-TNF) are established treatments for Crohn's disease (CD).
- Assessing structural intestinal damage, beyond mucosal healing, during anti-TNF therapy requires further investigation.
- Small-intestine contrast ultrasonography (SICUS) offers a valuable method for evaluating CD lesions.
Purpose of the Study:
- To evaluate the utility of a novel sonographic lesion index for CD (SLIC) in monitoring transmural bowel damage.
- To assess changes in SLIC scores in Crohn's disease patients undergoing anti-TNF therapy.
Main Methods:
- A prospective study involving 29 patients with ileal or ileocolonic CD treated with anti-TNF agents.
- SICUS was performed before and after induction and maintenance anti-TNF therapy.
- A control group of 7 patients with ileal CD treated with mesalamine was included to assess therapy-independent changes.
Main Results:
- Significant improvements in SLIC scores and subscores were observed after anti-TNF induction and maintenance therapy.
- Patients achieving clinical response (steroid-free remission, CD activity index < 150) showed greater SLIC improvements.
- Control patients receiving mesalamine did not exhibit significant changes in CD activity index or SLIC scores.
Conclusions:
- The quantitative SLIC, assessed by SICUS, is a reliable tool for monitoring transmural bowel damage in Crohn's disease patients.
- SLIC changes correlate with clinical response to anti-TNF therapy.
- Sonographic assessment provides objective insights into treatment efficacy for structural damage in CD.
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