title: Mucosal healing in Crohn's disease:  a systematic review.
abstract: The traditional goals of Crohn's disease therapy, to induce and maintain clinical remission, have not clearly changed its natural history. In contrast, emerging evidence suggests that achieving and maintaining mucosal healing may alter the natural history of Crohn's disease, as it has been associated with more sustained clinical remission and reduced rates of hospitalization and surgical resection. Induction and maintenance of mucosal healing should therefore be a goal toward which therapy is now directed. Unresolved issues pertain to the benefit of achieving mucosal healing at different stages of the disease, the relationship between mucosal healing and transmural inflammation, the intensity of treatment needed to achieve mucosal healing when it has not been obtained using standard therapy, and the means by which mucosal healing is defined using current endoscopic disease activity indices. The main clinical challenge relates to defining the means of achieving high rates of mucosal healing in clinical practice.
authors.affiliation: Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: De Cruz
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kamm
authors.forename: Lani
authors.initials: L
authors.lastname: Prideaux
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Allen
authors.forename: Greg
authors.initials: G
authors.lastname: Moore
mesh_terms: D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D016903:Drug Monitoring; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D060828:Induction Chemotherapy; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D060046:Maintenance Chemotherapy; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D007166:Immunosuppressive Agents