Crohn’s Disease: Basic Characteristics of the Disease, Diagnostic Methods, the Role of Biomarkers, and Analysis of Metalloproteinases: A Review

Abstract

Crohn’s disease is a chronic inflammatory bowel disease that affects the ileum and/or large intestine. At the same time, it can also affect any other part of the human body, i.e., from the mouth to the anus. In Crohn’s disease, the physiology and functioning of the epithelial barrier are inhibited due to the correlation of various factors, such as the environment, genetic susceptibility or intestinal microbiota. The symptoms are very troublesome and cause a significant reduction in quality of life, sometimes occurring with paralyzing permanent damage to the digestive tract, requiring enteral or parenteral nutrition throughout life. In order to make a proper and accurate diagnosis, an appropriately selected diagnostic path in a given clinical entity is necessary. Standard diagnostic methods are: laboratory examination, histopathological examination, endoscopic examination, X-ray, computed tomography, ultrasound examination and magnetic resonance imaging. Medical biology and the analysis of metalloproteinases have also proved helpful in diagnosing changes occurring as a result of Crohn’s disease. Here we provide a thorough review of the latest reports on Crohn’s disease and its genetic conditions, symptoms, morphology, diagnosis (including the analysis of Crohn’s disease biomarkers, i.e., metalloproteinases) and treatment.

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“…These can mimic various gastrointestinal disorders, including malignancies, and require extensive investigations to diagnose and surgical excisions in uncontrolled cases [ 7 , 8 , 9 , 10 ]. The prevalence of CD varies globally, with recent estimates indicating an increasing incidence in both developed and developing countries, suggesting that environmental and lifestyle factors play critical roles in its pathogenesis alongside genetic susceptibilities [ 11 , 12 ]. Moreover, uncontrolled systemic inflammation and oxidative stress involved in chronic conditions was shown to increase the predisposition of cancers [ 13 , 14 , 15 , 16 ].…”

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“…In UC, inflammation is mainly restricted to the mucosa and involves only the colon, although the extent of colic involvement may vary among patients and over time [ 2 ]. In CD, the inflammatory process is transmural and affects any portion of the gastrointestinal tract, from the mouth to the anus, and may be associated with penetrating phenomena such as intraperitoneal abscesses or fistulas [ 3 ]. Although the etiology is unknown, it is believed that the interaction between environmental factors and the gut microbiota of a genetically susceptible host leads to the abnormal immune response of the colic mucosa observed in these diseases [ 4 ].…”