A modern approach to understanding intestinal fibrosis. Review

Inflammatory bowel diseases, especially ulcerative colitis and Crohn’s disease, are characterized by inflammation and progressive damage to intestinal tissue, leading to uncontrolled proliferation of mesenchymal cells and the development of intestinal strictures. Intestinal fibrosis is a chronic, progressive disease that develops as a complication of persistent and long‑term inflammation associated with inflammatory bowel disease. It affects more than one‑third of patients with inflammatory bowel disease within 10 years of the onset of the disease. This review aims to complete the possibilities of the mechanism of pathogenesis of intestinal fibrosis and to identify key biomarkers of fibrogenesis. Electronic databases, including PubMed, Scopus, Google, and Google Scholar, were searched using keywords such as «intestinal fibrosis». This review focuses on studies conducted between 1986 and 2024 using experimental models of intestinal fibrosis in vivo and in vitro. It also highlights some of the advantages of identifying biomarkers for predicting intestinal fibrosis. The review examines the main molecular mediators of intestinal fibrogenesis and summarizes the development and advancement of technologies for visualizing intestinal fibrosis. Assessment of disease activity and severity of complications is of paramount importance in defining treatment strategies at all stages of the disease, and the possibility of monitoring disease activity and treatment outcomes. Complications caused by tissue fibrosis contribute to an increase in the incidence and mortality of inflammatory bowel diseases, resulting in an increased number of hospitalizations and surgical procedures, which significantly increases the burden on the healthcare system. The development of accessible and reliable biomarkers of fibrogenesis is important in strengthening diagnostic and prognostic methods of treatment of inflammatory bowel diseases, which in turn significantly contributes to the intensification of pharmacotherapy, the use of surgical treatment methods, and monitoring the effectiveness of antifibrotic therapy.