PMID- 19637358
OWN - NLM
STAT- MEDLINE
DCOM- 20091211
LR  - 20220316
IS  - 1536-4844 (Electronic)
IS  - 1078-0998 (Linking)
VI  - 15
IP  - 10
DP  - 2009 Oct
TI  - Etiology of perianal Crohn's disease: role of genetic, microbiological, and 
      immunological factors.
PG  - 1591-8
LID - 10.1002/ibd.21026 [doi]
AB  - Perianal fistulation is a common complication of Crohn's disease (CD). 
      Fistulating perianal CD appears to represent a distinct phenotype of CD, separate 
      from luminal fistulating disease, with differing disease behavior and which often 
      requires different therapeutic strategies. The etiology of Crohn's perianal 
      fistulae appears to have genetic, microbiological, and immunological components. 
      Relationships with IBD5, which codes for the organic/cation transporter and IRGM, 
      important in the autophagy pathway, have been identified but further genetic 
      associations remain elusive. The partially efficacious use of antibiotics and 
      fecal diversion imply a microbiological component and, similarly, the partial 
      efficacy of immunosuppressants and anti-tumor necrosis factor alpha (TNFalpha) 
      treatments suggest not only that an immunological process is taking place, but 
      also that microbiota alone cannot account for the pathogenesis. Recent work 
      implicates failures in the tissue injury/repair process with myofibroblasts, 
      matrix metalloproteinases, and an epithelial-to-mesenchymal transition being 
      possible culprits. We examine these areas in a review of the current 
      understanding of the etiology of Crohn's perianal fistulae.
FAU - Tozer, Philip J
AU  - Tozer PJ
AD  - St Mark's Hospital, London, UK. p.tozer08@imperial.ac.uk
FAU - Whelan, Kevin
AU  - Whelan K
FAU - Phillips, Robin K S
AU  - Phillips RK
FAU - Hart, Ailsa L
AU  - Hart AL
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - Inflamm Bowel Dis
JT  - Inflammatory bowel diseases
JID - 9508162
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Anus Diseases/*etiology/surgery
MH  - Crohn Disease/*etiology/surgery
MH  - Humans
MH  - Immunologic Factors
RF  - 75
EDAT- 2009/07/29 09:00
MHDA- 2009/12/16 06:00
CRDT- 2009/07/29 09:00
PHST- 2009/07/29 09:00 [entrez]
PHST- 2009/07/29 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - 10.1002/ibd.21026 [doi]
PST - ppublish
SO  - Inflamm Bowel Dis. 2009 Oct;15(10):1591-8. doi: 10.1002/ibd.21026.