|Stricturing and penetrating disease are classified as severe Crohnâs disease types and are frequently associated with an increased risk for bowel surgery. early treatment with aggressive immunosuppression (including biological and thiopurine therapies â the so-called âtop-down approachâ) results in a diminished risk of developing these complicated disease types. the role of NOD2 and other gene polymorphisms in predicting Crohnâs disease severity. It also highlights the evidence linking the role of the various antibodies involved in adaptive immunity (ASCA, OmpC, GM-CSF) and complicated Crohnâs disease types. using potent immunosuppressants in all CD patients may expose patients with mild CD to an increased risk of side-effects from these immunomodulators and biological agents, this approach may help identify which patients would benefit from aggressive immunosuppression at an early stage.
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