Biomaterial Database

The pathogenesis of Crohn's disease. 1994

R E Pounder

University Department of Medicine, Royal Free Hospital School of Medicine, London, UK.

This paper describes a program of research undertaken by the Inflammatory Bowel Disease Study Group at the Royal Free Hospital School of Medicine. The Group has tested the hypothesis that the primary pathological abnormality in Crohn's disease is in the mesenteric blood supply. The first experiments involved microcorrosion resin casting of the arterial supply of specimens of resected intestine affected by Crohn's disease. This revealed severe damage to submucosal blood vessels, even in areas that were not affected macroscopically by Crohn's disease. Resected specimens of bowel were examined after perfusion-fixation: 85% of granulomas were associated with blood vessels, demonstrating that Crohn's disease is a granulomatous vasculitis. Patients with Crohn's disease usually have one or more features of a hypercoagulable state, which may increase the risk of ischemic damage. A model of Crohn's disease was developed in the ferret intestine, by embolizing mesenteric blood vessels using latex particles. Acute embolization results in patchy necrosis of the mucosa, with subsequent recovery. Surgical incision and anastomosis in a previously embolized area results in intense ulceration--suggesting that recurrent Crohn's disease after surgery is due to a second ischemic insult to an already damaged intestine. Finally, electron microscope studies have investigated the mesenteric vascular endothelium associated with granulomata in Crohn's disease. Viral particles have been identified within the vascular endothelium, with the appearance of paramyxoviridae. In situ hybridization and other studies suggest that these particles are measles virus.(ABSTRACT TRUNCATED AT 250 WORDS)

UI	MeSH Term	Description	Entries
D007238	Infarction	Formation of an infarct, which is NECROSIS in tissue due to local ISCHEMIA resulting from obstruction of BLOOD CIRCULATION, most commonly by a THROMBUS or EMBOLUS.	Infarct,Infarctions,Infarcts
D007413	Intestinal Mucosa	Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI.	Intestinal Epithelium,Intestinal Glands,Epithelium, Intestinal,Gland, Intestinal,Glands, Intestinal,Intestinal Gland,Mucosa, Intestinal
D008643	Mesentery	A layer of the peritoneum which attaches the abdominal viscera to the ABDOMINAL WALL and conveys their blood vessels and nerves.	Mesenteries
D003424	Crohn Disease	A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients.	Colitis, Granulomatous,Enteritis, Granulomatous,Enteritis, Regional,Ileitis, Regional,Ileitis, Terminal,Ileocolitis,Crohn's Disease,Crohn's Enteritis,Inflammatory Bowel Disease 1,Regional Enteritis,Crohns Disease,Granulomatous Colitis,Granulomatous Enteritis,Regional Ileitides,Regional Ileitis,Terminal Ileitis
D004064	Digestive System	A group of organs stretching from the MOUTH to the ANUS, serving to breakdown foods, assimilate nutrients, and eliminate waste. In humans, the digestive system includes the GASTROINTESTINAL TRACT and the accessory glands (LIVER; BILIARY TRACT; PANCREAS).	Ailmentary System,Alimentary System
D004195	Disease Models, Animal	Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases.	Animal Disease Model,Animal Disease Models,Disease Model, Animal
D005289	Ferrets	Semidomesticated variety of European polecat much used for hunting RODENTS and/or RABBITS and as a laboratory animal. It is in the subfamily Mustelinae, family MUSTELIDAE.	Domestic Polecat,Domestic Polecats,European Polecat,European Polecats,Ferret,Mustela putorius,Mustela putorius furo,Polecat, Domestic,Polecat, European,Polecats, Domestic,Polecats, European
D006099	Granuloma	A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents.	Granulomas
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia