Chron’s Disease is a chronic inflammatory intestinal disease, first described at the beginning of the last century. The disease is characterized by the alternation of periods of flares and remissions influenced by a complex pathogenesis in which inflammation plays a key role. Crohn’s disease evolution is mediated by a complex alteration of the inflammatory response which is characterized by alterations of the innate immunity of the intestinal mucosa barrier together with a remodeling of the extracellular matrix through the expression of metalloproteins and increased adhesion molecules expression, such as MAcCAM-1. This reshaped microenvironment enhances leucocytes migration in the sites of inflammation, promoting a TH1 response, through the production of cytokines such as IL-12 and TNF-α. IL-12 itself and IL-23 have been targeted for the medical treatment of CD. Giving the limited success of medical therapies, the treatment of the disease is invariably surgical. This review will highlight the role of inflammation in CD and describe the surgical approaches for the prevention of the almost inevitable recurrence.

中文翻译：

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克罗恩病炎症和复发的病理生理学

慢性病是一种慢性炎症性肠道疾病，上世纪初首次被描述。该疾病的特征在于受炎症起关键作用的复杂发病机制影响的发作期和缓解期的交替。克罗恩病的演变是由炎症反应的复杂改变介导的，炎症反应的特征是肠粘膜屏障的先天免疫改变以及细胞外基质通过金属蛋白的表达和粘附分子表达的增加，如 MACCAM- 1. 这种重塑的微环境通过产生 IL-12 和 TNF-α 等细胞因子，增强了白细胞在炎症部位的迁移，促进了 TH1 反应。IL-12 本身和 IL-23 已成为 CD 药物治疗的目标。鉴于药物疗法的成功有限，该疾病的治疗总是外科手术。本综述将强调炎症在 CD 中的作用，并描述预防几乎不可避免的复发的手术方法。