Contemporary Views on the Genesis and Development of Crohn’s Disease

Overview

Among etiological factors suspected of causing Crohn’s disease a number of bacteria was listed (Yersinia,Mycobacterium kansasi, Mycobacterium pseudotuberculosis) as well as viruses (measles). None of them howevercan be considered as the only agent. As to external influences, we know the adverse effect of smoking, the toxiceffect Al and oral contraceptives. The listed causes may enhance the development of mesenteric thromboses orimmunocomplex vasculitis with ischaemization of a certain portion of the small or large intestine with subsequentinflammation. So far we do not know what starts the immunological reaction, but subsequently the process takesplace via cytokines, prostaglandin PGE2, leukotriene LTB4 and liberation of free oxygen radicals (this knowledgeis applied in therapy). The authors discuss the problem whether Crohn’s disease is one clinical entity with a differentcourse or whether a single diagnosis comprises two or more pathological units.

Key words:
Crohn’s disease, endoscopic diagnosis, ulcerative colitis, cytokines, granulomatous immunocomplexvasculititis, microelements (trace elements), smoking.