Authors: Albert Boronat-Toscano, Diandra Monfort-Ferré, Margarita Menacho, Aleidis Caro, Ramon Bosch, Beatriz Espina, Francisco Algaba-Chueca, Alfonso Saera-Vila, Alicia Moliné, Marc Marti, Eloy Espin, Mónica Millan, and Carolina Serena.


  • Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari Joan XXIII, Universitat Rovira i Virgili, 43007 Tarragona, Spain
  • Digestive Unit, Hospital Universitari Joan XXIII, 43007 Tarragona, Spain
  • Colorectal Surgery Unit, Hospital Universitari Joan XXIII, 43007 Tarragona, Spain
  • Department of Pathology, Oncological Pathology and Bioinformatics Research Group, Hospital de Tortosa Verge de la Cinta—IISPV, 43500 Tortosa, Spain
  • Sequentia Biotech, Carrer Comte D’Urgell 240, 08036 Barcelona, Spain
  • Colorectal Surgery Unit, General Surgery Service, Hospital Valle de Hebron, Universitat Autonoma de Barcelona, 08035 Barcelona, Spain
  • Colorectal Surgery Unit, General Surgery Service, Hospital La Fe, 46026 Valencia, Span

Publication: International Journal of Molecular Sciences

Date: October, 2022




Anti-TNF biologics have been shown to markedly improve the quality of life for patients with Crohn’s disease (CD), yet one-third of patients fail to benefit from this treatment. Patients with CD develop a characteristic wrapping of visceral adipose tissue (VAT) in the inflamed intestinal area, termed creeping fat, and it is known that adipose tissue expansion influences the efficacy of anti-TNF drugs. We questioned whether anti-TNF therapies impact the creeping fat in CD, which might affect the outcome of the disease. Adipose tissue biopsies were obtained from a cohort of 14 patients with CD that received anti-TNF drugs and from 29 non-anti-TNF-treated patients (control group) matched by sex, age, and body mass index undergoing surgical interventions for symptomatic complications. We found that anti-TNF therapies restored adipose tissue morphology and suppressed immune cell infiltration in the creeping fat. Additionally, anti-TNF treatments appeared to markedly improve the pro-inflammatory phenotype of adipose-tissue macrophages and adipose-tissue-derived stem cells. Our study provides evidence that anti-TNF medications influence immune cells and progenitor cells in the creeping of patients with CD, suppressing inflammation. We propose that perilesional VAT should be considered when administering anti-TNF therapy in patients with CD.