Creeping fat and gut microbiota in Crohn’s disease

Table 1 Mechanisms involved in the formation and maintenance of creeping fat in Crohn’s disease

Mechanism	Description	Ref.
Bacterial translocation	Migration of bacteria from the intestinal lumen to the mesenteric adipose tissue, stimulating local inflammation	Ha et al[22]
Chronic inflammation	Continuous production of inflammatory cytokines (such as tumor necrosis factor-α, interleukin-6, and interleukin-1β) that affect the mesentery	Wu et al[14]; Foppa et al[24]
Local adipokine production	Release of leptin and adiponectin from adipose tissue, which modulates the immune and inflammatory responses	Tsounis et al[19]
Hypoxia and local fibrosis	The expansion of mesenteric fat can generate hypoxia, favoring fibrosis and aggravating the inflammatory condition	Wu et al[14]; Li et al[33]
Alteration of gut microbiota	Changes in the composition of the intestinal microbiota that affect the metabolism and function of the adipose tissue	Gilliland et al[4]; Ha et al[22]
Activation of macrophages and T cells	Infiltration of macrophages and T cells into adipose tissue, perpetuating inflammation and tissue remodeling	Karaskova et al[12]; Tsounis et al[19]