Crohn's disease: on the occasion of the 80th anniversary of description


Cite item

Full Text

Abstract

In 1932, Burrill Bernard Crohn, Leon Ginzburg, and Gordon Oppenheimer published the paper "Regional ileitis: a pathological and clinical entity" first describing terminal ileitis that took further its name from B. Crohn. Crohn's disease (CD) is a recurring systemic inflammatory disease affecting the gastrointestinal tract (GIT) with extraintestinal manifestations and systemic immune disorders. Its etiology is unknown; the pathogenesis is associated with congenital impairments in the intestinal barrier and immune response to diversified symbiotic bacteria. The classification and the specific features of the natural history of CD are presented; the possibilities of new methods for its diagnosis and treatment are shown. Its new treatment goals are formulated; these are to achieve complete recovery of the involved bowel wall; to use confocal endoscopy, ultrasonography, magnetic resonance imaging, computed tomography, positron emission tomography, and the biomarkers C-reactive protein, fecal calprotectin, and lactoferritin. Algorithms for CD diagnosis and treatment using anticytokine agents and mesenchymal stromal stem cells are given.

Full Text

Болезнь Крона: к 80-летию описания. - Аннотация. В 1932 г. Беррилл Бернард Крон, Леон Гинзберг и Гордон Оппенгеймер опубликовали статью "Региональный илеит: патологическая и клиническая сущность", в которой впервые описали терминальный илеит, получивший в дальнейшем имя Б. Крона. Болезнь Крона (БК) - рецидивирующая системная воспалительная болезнь, поражающая желудочно-кишечный тракт (ЖКТ) с внекишечными проявлениями и системными иммунологическими нарушениями. Этиология БК неизвестна, патогенез связан с врожденными нарушениями кишечного барьера и иммунного ответа на разнообразную симбионтную микрофлору. Изложены классификация, особенности естественного течения БК, показаны возможности новых методов диагностики и лечения. Сформулированы новые цели лечения - достижение полного восстановления стенки пораженной кишки, использование конфокальной эндоскопии, ультразвукового исследования, магнитно-резонансной томографии, компьютерной томографии и позитронно-эмиссионной томографии, а также биомаркеров - С-реактивного белка, фекального кальпротектина и лактоферритина. Приведены алгоритмы диагностики и лечения БК с использованием антицитокиновых агентов и мезенхимальных стромальных стволовых клеток.
×

About the authors

A I Parfenov

Email: asfold@mail.ru

References

  1. Crohn's Disease and Ulcerative Colitis - From Epidemiology and Immunobiology to a Rational Diagnostic and Therapeutic Approach. Baumgart DC, ed. New York: Springer 2012.
  2. Lee A., Griffiths .A., Parab R.S. et al. Association of Mycobacterium avium subspecies paratuberculosis with Crohn Disease in pediatric patients. J Pediatr Gastroenterol Nutr 2011; 52: 170-174.
  3. Nakase H., Tamaki H., Matsuura M. et al. Involvement of mycobacterium avium subspecies paratuberculosis in TNF-α production from macrophage: Possible link between MAP and immune response in Crohn's disease. Inflammatory bowel diseases. 2011; 17 (11): E140-E142.
  4. Barreau F., Madre C., Meinzer U. et al. Nod2 regulates the host response towards microfl ora by modulating T cell function and epithelial permeability in mouse Peyer's patches. Gut 2010; 59: 207-217.
  5. Baumgart D., Sandborn W. Crohn's Disease. The Lancet 2012; 380 (9853): 1590-1605.
  6. Colombel J.F., Sandborn W.J., Reinisch W. et al. Infliximab, azathioprine, or combination therapy for Crohn's disease. N Engl J Med 2010; 362: 1383-1395.
  7. Cosnes J., Cattan S., Blain A. et al. Long-term evolution of disease behavior of Crohn's disease. Inflamm Bowel Dis 2002; 8: 244-250.
  8. Al-Hawary M., Zimmermann E.M. A New Look at Crohn's Disease. Novel Imaging Techniques. Curr Opin Gastroenterol 2012; 28 (4): 334-340.
  9. Ferrante M., Henckaerts L., Joossens M. et al. New serological markers in inflammatory bowel disease are associated with complicated disease behaviour. Gut 2007; 56 (10): 1394-1403.
  10. Seow C.H., Stempak J.M., Xu W. et al. Novel anti-glycan antibodies related to inflammatory bowel disease diagnosis and phenotype. Am J Gastroenterol 2009; 104 (6): 1426-1434.
  11. Perencevich M., Burakoff R. Use of antibiotics in the treatment of inflammatory bowel disease. Inflamm Bowel Dis 2006; 12 (7): 651-664.
  12. Khan K., Ullman T., Ford A. et al. Antibiotic therapy in inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2011; 106 (4): 661-673.
  13. Dignass A., Van Assche G., Lindsay J.O. et al. The second European evidence-based consensus on the diagnosis and management of Crohn's Disease: current management. J. Crohn's Colitis.2010; 4: 28-62.
  14. Gordon M., Naidoo K., Thomas A.G., Akobeng A.K. Oral 5-aminosalicylic acid for maintenance of surgically-induced remission in Crohn's disease. Cochrane Database Syst Rev 2011; 1: CD008414.
  15. Seow C.H., Benchimol E.I., Griffiths A.M. et al. Budesonide for induction of remission in Crohn's disease. Cochrane Database Syst Rev 2008; CD000296.
  16. Dignass A., Van Assche G., Lindsay J.O. et al. The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: current management. J. Crohns Colitis 2010; 4: 28-62.
  17. Peyrin-Biroulet L., Deltenre P., Ardizzone S. et al. Azathioprine and 6-mercaptopurine for the prevention of postoperative recurrence in Crohn's disease: a meta-analysis. Am J Gastroenterol 2009; 104: 2089-2096.
  18. Lin M.V., Blonski W., Lichtenstein G.R., Present D.H. What is the optimal therapy for Crohn's disease: step-up or top-down? Expert Rev Gastroenterol Hepatol 2010; 4: 167-180.
  19. Князев О.В., Парфенов А.И., Ручкина И.Н. и др. Новые возможности преодоления вторичной неэффективности антицитокиновой терапии у больных воспалительными заболеваниями кишечника. Тер арх 2013; 2: 57-60.
  20. Neurath M.F., Travis S.P.L. Mucosal healing in inflammatory bowel diseases: a systematic review. Gut 2012; 61 (11): 1619-1635.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2013 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies