Pathophysiology of Crohn's disease inflammation and recurrence.
L Petagna, A Antonelli, C Ganini, V Bellato, M Campanelli, A Divizia, C Efrati, M Franceschilli, A M Guida, S Ingallinella, F Montagnese, B Sensi, L Siragusa, G S Sica
Author Information
L Petagna: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
A Antonelli: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
C Ganini: Torvergata Oncoscience Research Centre of Excellence, TOR, Department of Experimental Medicine, University Tor Vergata, Rome, Italy. ORCID
V Bellato: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
M Campanelli: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
A Divizia: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
C Efrati: Ospedale Israelitico, Department of Gastroenterology, Rome, Italy.
M Franceschilli: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
A M Guida: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
S Ingallinella: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
F Montagnese: Nuovo Ospedale dei Castelli, Endoscopy Unit, Rome, Italy.
B Sensi: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
L Siragusa: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. ORCID
G S Sica: Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. sigisica@gmail.com. ORCID
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 T1 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.
