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Promoting mucosal healing by targeting TMEM219-dependent intestinal epithelial stem cell defects in inflammatory bowel disease
Nicolas Schlegel
Nicolas Schlegel
Published May 15, 2025
Citation Information: J Clin Invest. 2025;135(10):e192640. https://doi.org/10.1172/JCI192640.
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Commentary

Promoting mucosal healing by targeting TMEM219-dependent intestinal epithelial stem cell defects in inflammatory bowel disease

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Abstract

Inflammatory Bowel Diseases (IBD), including Crohn’s disease and ulcerative colitis, pose challenges due to their complex pathophysiology and high prevalence. Despite advances in immune-targeted therapies, a substantial number of patients fail to achieve mucosal healing, highlighting the need for alternative therapeutic strategies. In this issue of the JCI, D’Addio et al. identified another mechanism underlying impaired epithelial regeneration in Crohn’s disease. They found that abnormal cell death in intestinal epithelial stem cells, mediated by altered TMEM219 signaling, led to impaired mucosal healing. Targeting TMEM219 with ecto-TMEM219, which blocks its activation, restored stem cell function and promoted mucosal healing in vitro and in vivo. These findings suggest a promising therapeutic avenue focusing on epithelial repair. Additionally, patient-derived organoids (PDOs) emerge as a valuable tool for personalized treatment strategies and for advancing the field of IBD research. This study underscores the importance of epithelial cell biology in developing innovative IBD therapies.

Authors

Nicolas Schlegel

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Figure 1

Targeting TMEM219-dependent intestinal epithelial stem cell defects promotes mucosal healing.

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Targeting TMEM219-dependent intestinal epithelial stem cell defects prom...
(A) Patients with refractory or active Crohn’s disease showed overactive TMEM219 signaling that correlated with a failure to regenerate the mucus layer, despite immune suppression. TMEM219 contributed to cell death in intestinal epithelial stem cells. In mini-guts derived from patients with Crohn’s disease, targeting the TMEM219 axis using ecto-TMEM219 restored self renewal. Beyond standard immune-targeted treatments, clinically targeting intestinal epithelial cells using TMEM219 blockade may promote mucosal healing. Moreover, PDOs provide a personalized-screening platform for identifying compounds that optimize mucosal restoration. (B) ecto-TMEM219 also ameliorated mucosal healing in DSS-induced and T cell–mediated colitis models.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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