Mechanisms that mediate the development of fibrosis in patients with Crohn's disease.
Mechanisms that mediate the development of fibrosis in patients with Crohn's disease.
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DOI：
10.1097/mib.0000000000000043
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发表时间：
2014-07
影响因子：
4.9
通讯作者：
Kuemmerle JF
中科院分区：
文献类型：
--
作者：
Li C;Kuemmerle JF
Crohn’s disease is complicated by the development of fibrosis and stricture in ~30–50% of patients over time. The pathogenesis of fibrostenotic disease is multifactorial involving the activation of mesenchymal cells by cytokines, growth factors and other mediators released by immune cells, epithelial cells and mesenchymal cells themselves. Transforming growth factor-β (TGF-β), a key activator of mesenchymal cells, is central to the process of fibrosis and regulates numerous genes involved in the disordered wound healing including collagens, and other extracellular matrix proteins, connective tissue growth factor (CTGF), and insulin-like growth factors (IGFs). The activated mesenchymal compartment is expanded by recruitment of new mesenchymal cells via epithelial to mesenchymal transition, endothelial to mesenchymal transition and invasion of circulating fibrocytes. Cellular hyperplasia and increased extracellular matrix (ECM) production, particularly collagens, from fibroblasts, myofibroblasts and smooth muscle cells add to the disturbed architecture and scarring on the intestine. ECM homeostasis is further disrupted by alterations in the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) in the gut. Among the 163 susceptibility genes identified that contribute to susceptibility in IBD mutations in NOD2/CARD15, innate immune system components, and autophagy jointly contribute to the activation of mesenchymal cells and pathogenesis of fibrosis in this polygenic disorder. Numerous growth factorscytokinesand other mediators. The review focuses on the molecular mechanism that regulate mesenchymal cell function, particularly smooth muscle cells, the largest compartment of mesenchyme in the intestine, that lead to fibrosis in Crohn’s disease.
