Immunologie der Stenoseentstehung bei Morbus Crohn

Zusammenfassung

Mehr als ein Drittel der Patienten mit Morbus Crohn entwickeln intestinale Stenosen mit nachfolgender Notwendigkeit einer chirurgischen Therapie. Während die Pathophysiologie der Entzündungsreaktion des Morbus Crohn intensiv untersucht wird, ist das Wissen über die Fibrogenese eher mangelhaft. Der fibrotische intestinale Organumbau resultiert aus einem komplexen Zusammenspiel von genetischen Faktoren, akuten und chronischen Entzündungsreaktionen, Aktivierung von mesenchymalen Zellen und der zeitgerechten Expression von verschiedenen proinflammatorischen und profibrotischen Zytokinen. Die Kombination dieser Faktoren bedingt die überschießende Ablagerung extrazellulärer Matrix mit konsekutiver Fibrose des Intestinums. Durch die Erforschung der pathophysiologischen Grundlagen der Fibrogenese des Morbus Crohn kann die Basis für eine spezifische antifibrotische Therapie gebildet werden.

Abstract

Over one-third of patients with Crohn's disease eventually will develop intestinal stenosis with the need for surgical intervention. While the pathophysiology of the inflammatory response in Crohn's disease has been investigated extensively, the knowledge of intestinal fibrogenesis is limited. Fibrotic organ remodelling results from a complex interplay of genetic factors, acute and chronic inflammation, activation of mesenchymal cells and the timely expression of several proinflammatory and profibrotic cytokines. The combination of those factors leads to enhanced deposition of extracellular matrix with consecutive fibrosis of the intestine. Through investigation of the pathophysiologic processes of the fibrogenesis in Crohn's disease the basis for specific antifibrotic therapies can be built.

Schlüsselwörter

Fibrose - Stenose - Morbus Crohn

Key words

Fibrosis - Stenosis - Crohn's disease

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