Pathogenesis of Crohn's disease

Abstract

Significant progress in our understanding of Crohn's disease (CD), an archetypal common, complex disease, has now been achieved. Our ability to interrogate the deep complexities of the biological processes involved in maintaining gut mucosal homeostasis is a major over-riding factor underpinning this rapid progress. Key studies now offer many novel and expansive insights into the interacting roles of genetic susceptibility, immune function, and the gut microbiota in CD. Here, we provide overviews of these recent advances and new mechanistic themes, and address the challenges and prospects for translation from concept to clinic.

Multiple healthcare-associated infections in a patient with Crohn's disease: Case report

“…11 All species identified are commonly associated to nosocomial infections worldwide and contribute to the increase in morbi-mortality of immunocompromised individuals. 4,6 On the other hand, the patient presented here survived after antimicrobial therapy against multiple infections in a short period.…”

“…5 The most common symptoms are abdominal pain, bowel obstruction and diarrhea, often prompting individuals affected to corrective surgeries and long hospitalization periods, which increases the risk of infections. 5,6 The aim of this work was to evaluate and to describe an interesting case of a patient with DC and multiple HAIs, when microorganisms were isolated in different clinical specimens in a short period.…”

Extra-Intestinal Complications (EIC) and Manifestations (EIM) (Ocular and Pulmonary) among Patients with Crohn's Disease

“…An interactions among several factors, including genetic factors, host immune system and environmental Factors (including diets and microbiological agents), play pivotal roles in disturbing the intestinal homeostasis, resulting on dysregulated inflammatory responses of the alimentary tract [14,15]. CD has a complex etiology, an immune-mediated condition in genetically susceptible individuals is the most widely accepted hypothesis for the etiology of CD, the onset of the disease is provoked by environmental factors that upset the mucosal barrier, alter the healthy balance of the gut flora, and abnormally stimulate gut immune responses [16]. Sartor accentuated that based on studying the genetics of CD; four genes have been related to the pathogenesis of CD while others will be related with extra intestinal manifestations as HLA-B27 and HLA-DR0103 human leukocyte antigen haplotypes.…”

Management of Crohnʼs Disease in the New Era of Gut Rehabilitation and Intestinal Transplantation

“…[144][145][146][147] Of the incriminating pathogenic pathways for both CD development and destructive alloimmunity, is impaired innate immunity with Paneth cell dysfunction due to different genetic mutations including NOD1 and NOD2 genes. 36,[133][134][135][148][149][150][151][152][153][154][155][156][157][158] It remains to be seen if inclusion of the donor liver with the intestinal allograft will have a long-term protective effect on disease recurrence similar to what has been documented with alloimmunity. 159,160 Nonetheless, the current data with up to 25 years of follow-up showed no significant impact of CD recurrence on survival outcome and long-term allograft function.…”