Yarur AJ, et al. - In this prospective, cross-sectional study, researchers assessed whether patients with nonresponse to anti-tumor necrosis factor (TNF) agents have increased expression of alternative cytokine pathways. Participants in the study were patients with Crohn’s disease receiving anti-TNF undergoing colonoscopy with adequate serum trough drug levels (≥8 µg/mL) and without anti-drug antibodies. There were a total of 47 patients. When compared with patients without intestinal inflammation, those with active inflammation had significantly higher levels of intercellular adhesion molecule-1 (ICAM-1) and interleukin (IL)-1β. According to findings, patients with active inflammation with apparently adequate levels of serum anti-TNF have increased levels of specific inflammatory pathways that can serve as biomarkers of nonresponse and potential therapeutic targets in anti-TNF nonrespondents.