What is the pathogenesis of pediatric Crohn disease?

Updated: Oct 23, 2018
  • Author: Andrew B Grossman, MD; Chief Editor: Carmen Cuffari, MD  more...
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The pathogenesis of Crohn disease is multifactorial. After a triggering event occurs in a genetically susceptible individual, an altered immune response leads to chronic inflammation of the intestine. Although the etiology of the precipitating event is unknown, luminal bacteria or specific antigens are thought to be involved.

Chronic inflammation from T-cell activation leading to tissue injury is implicated. After activation by antigen presentation, unrestrained responses of helper lymphocytes type 1 (Th1) predominate because of defective regulation. Th1 cytokines (eg, interleukin [IL]–12 and tumor necrosis factor [TNF]-α) stimulate the inflammatory response. Inflammatory cells recruited by these cytokines release nonspecific inflammatory substances (eg, arachidonic acid metabolites, proteases, platelet activating factor, and free radicals), which directly injure the intestine.

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