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Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
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Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Letter: Upadacitinib in Perianal Crohn's Disease: Does Clinical Closure Reflect True Remission? Authors' Reply.

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Crohn's disease: Why the ileum?

Nicolas Richard1,2,3, Guillaume Savoye1,2,3, Mathilde Leboutte1,3

  • 1University of Rouen Normandie, INSERM, ADEN UMR 1073, Nutrition, Inflammation and Microbiota-Gut-Brain Axis, Rouen F-76000, France.

World Journal of Gastroenterology
|June 28, 2023
PubMed
Summary

Crohn's disease (CD) primarily affects the ileum, with unique genetic and environmental factors influencing its development. Further research is needed to identify targeted therapies for ileal CD, given its high rate of stricturing complications.

Keywords:
Bile acidsCrohn’s diseaseDietGeneticsIleumPaneth cellsStrictures

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Area of Science:

  • Gastroenterology
  • Immunology
  • Genetics

Background:

  • Crohn's disease (CD) is an inflammatory bowel disease with immune-mediated flares and remissions.
  • The ileum is frequently affected in CD, with a specific subtype presenting unique epidemiological features.
  • Paneth cell dysfunction and environmental factors like diet and smoking are implicated in ileal CD.

Purpose of the Study:

  • To highlight the distinct characteristics of ileal Crohn's disease.
  • To emphasize the need for a tailored therapeutic strategy for ileal CD.
  • To underscore the importance of understanding the interplay between genetics, environment, and ileal pathology.

Main Methods:

  • Review of epidemiological data and genetic associations in ileal CD.
  • Analysis of the role of environmental factors, diet, bile acids, and gut microbiota.
  • Comparison of transcriptome profiles and cellular processes between ileal and non-ileal CD.

Main Results:

  • Ileal CD exhibits a younger age of onset, strong links to smoking, and genetic susceptibility genes related to Paneth cells.
  • Dietary patterns influence bile acids and microbiota, affecting ileal inflammation susceptibility.
  • Distinct transcriptome profiles and differences in immune response and healing processes exist in ileal CD.

Conclusions:

  • The unique features of ileal CD warrant a dedicated therapeutic approach.
  • Current pharmacological studies lack site-specific response data, necessitating new therapeutic targets.
  • Addressing the high rate of stricturing disease in ileal CD is crucial for improving patient outcomes.