Crohn's disease: on the occasion of the 80th anniversary of description


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In 1932, Burrill Bernard Crohn, Leon Ginzburg, and Gordon Oppenheimer published the paper "Regional ileitis: a pathological and clinical entity" first describing terminal ileitis that took further its name from B. Crohn. Crohn's disease (CD) is a recurring systemic inflammatory disease affecting the gastrointestinal tract (GIT) with extraintestinal manifestations and systemic immune disorders. Its etiology is unknown; the pathogenesis is associated with congenital impairments in the intestinal barrier and immune response to diversified symbiotic bacteria. The classification and the specific features of the natural history of CD are presented; the possibilities of new methods for its diagnosis and treatment are shown. Its new treatment goals are formulated; these are to achieve complete recovery of the involved bowel wall; to use confocal endoscopy, ultrasonography, magnetic resonance imaging, computed tomography, positron emission tomography, and the biomarkers C-reactive protein, fecal calprotectin, and lactoferritin. Algorithms for CD diagnosis and treatment using anticytokine agents and mesenchymal stromal stem cells are given.

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Болезнь Крона: к 80-летию описания. - Аннотация. В 1932 г. Беррилл Бернард Крон, Леон Гинзберг и Гордон Оппенгеймер опубликовали статью "Региональный илеит: патологическая и клиническая сущность", в которой впервые описали терминальный илеит, получивший в дальнейшем имя Б. Крона. Болезнь Крона (БК) - рецидивирующая системная воспалительная болезнь, поражающая желудочно-кишечный тракт (ЖКТ) с внекишечными проявлениями и системными иммунологическими нарушениями. Этиология БК неизвестна, патогенез связан с врожденными нарушениями кишечного барьера и иммунного ответа на разнообразную симбионтную микрофлору. Изложены классификация, особенности естественного течения БК, показаны возможности новых методов диагностики и лечения. Сформулированы новые цели лечения - достижение полного восстановления стенки пораженной кишки, использование конфокальной эндоскопии, ультразвукового исследования, магнитно-резонансной томографии, компьютерной томографии и позитронно-эмиссионной томографии, а также биомаркеров - С-реактивного белка, фекального кальпротектина и лактоферритина. Приведены алгоритмы диагностики и лечения БК с использованием антицитокиновых агентов и мезенхимальных стромальных стволовых клеток.
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A Parfenov

Email: asfold@mail.ru

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