Pathophysiology of Crohn’s disease inflammation and recurrence

Abstract

Chron’s Disease is a chronic inflammatory intestinal disease, first described at the beginning of the last century. The disease is characterized by the alternation of periods of flares and remissions influenced by a complex pathogenesis in which inflammation plays a key role. Crohn’s disease evolution is mediated by a complex alteration of the inflammatory response which is characterized by alterations of the innate immunity of the intestinal mucosa barrier together with a remodeling of the extracellular matrix through the expression of metalloproteins and increased adhesion molecules expression, such as MAcCAM-1. This reshaped microenvironment enhances leucocytes migration in the sites of inflammation, promoting a TH1 response, through the production of cytokines such as IL-12 and TNF-α. IL-12 itself and IL-23 have been targeted for the medical treatment of CD. Giving the limited success of medical therapies, the treatment of the disease is invariably surgical. This review will highlight the role of inflammation in CD and describe the surgical approaches for the prevention of the almost inevitable recurrence.

Diagnostic and Predictive Value of Immune-Related Genes in Crohn’s Disease

“…Evidences have confirmed that CD is a chronic inflammatory intestinal disease, which is caused by an unrestrainable immune response against luminal bacterial antigens. The role of inflammatory cells infiltrating in maintaining an active stage is well established and most of the therapeutic strategies are aiming to block the cascade of inflammatory reaction and release of proinflammatory cytokines (14,15). In the present study, by analyzing the data for CD, non-inflammatory tissues, and normal intestinal tissues using ssGSEA, we described the landscape of immune infiltration in CD and found that the fraction of 16 immune cells was significantly different among these three kinds of tissues.…”

Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s Disease

“…The CSU and CD have a strong autoimmune involvement with an increase of proinflammatory cytokines (20). One common thread in the pathophysiology of both diseases is the imbalance in cytokine levels, in particular for IL-17 and TNF-a (21-23).…”

Ambulatory Surgery for Perianal Disease

“…Crohn's disease (CD) is an idiopathic, incurable chronic inflammatory disease of the GI tract [92][93][94][95], associated in more than 30% of cases to symptoms of perianal disease (PAD) [96][97][98]. The risk of developing PAD is consistent with the time from the diagnosis of CD, from 20% after ten years and up to 30% after twenty years.…”