Anti-TNF-α Biologics Do Not Reverse CDX2 Downregulation in Patients with Crohn's Disease.

OBJECTIVE: The caudal-related homeobox transcription factor 2 (CDX2) plays an important role in intestinal epithelial differentiation, proliferation, migration, and adhesion. It has been previously reported that TNF-α reduces CDX2 expression in cultured colon epithelial cells in a dose-dependent manner, and that this effect was reduced by adding the anti-TNF-α drug infliximab to the culture medium. The aim of this study was to determine whether CDX2 expression is reduced in biopsies from patients with Crohn's disease (CD), and whether treatment with anti-TNF-α drugs reverses CDX2 downregulation in these patients.

METHODS: Sections of ileocolonic biopsy tissues from patients with CD, CD treated with anti-TNF-α biologics (CD-T), and controls were stained for CDX2 and evaluated using OTMIAS digital image analysis.

RESULTS: CDX2 expression in biopsies from patients with CD and CD-T was lower than in controls ( p =0.0003). CDX2 expression in CD-T did not increase ( p =0.3292) and remained significantly lower than controls ( p =0.0002).

CONCLUSIONS: Although CDX2 is downregulated in CD, it did not revert to normal in patients treated with anti-TNF-α biologics.