Scharl M, Rogler G. Pathophysiology of fistula formation in Crohn's disease. World J Gastrointest Pathophysiol 2014; 5(3): 205-212 [PMID: 25133023 DOI: 10.4291/wjgp.v5.i3.205]
Corresponding Author of This Article
Dr. Michael Scharl, MD, PhD, Division of Gastroenterology and Hepatology, University Hospital Zürich, Rämistrasse 100, 8091 Zürich, Switzerland. michael.scharl@usz.ch
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Topic Highlight
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World J Gastrointest Pathophysiol. Aug 15, 2014; 5(3): 205-212 Published online Aug 15, 2014. doi: 10.4291/wjgp.v5.i3.205
Pathophysiology of fistula formation in Crohn's disease
Michael Scharl, Gerhard Rogler
Michael Scharl, Gerhard Rogler, Division of Gastroenterology and Hepatology, University Hospital Zürich, 8091 Zürich, Switzerland
Michael Scharl, Gerhard Rogler, Zurich Center for Integrative Human Physiology, University of Zürich, 8057 Zürich, Switzerland
Author contributions: Scharl M and Rogler G wrote and discussed the paper.
Supported by A grant from Fonds zur Förderung des akademischen Nachwuchses (FAN) of the Zürcher Universitätsverein (ZUNIV) to MS; by a research grant from the Swiss Philanthropy Foundation to MS and GR; by a research credit from the University of Zurich to MS; by research grants from the Swiss National Science Foundation (SNF) to MS, No. 314730-146204, GR, No. 310030-120312, and the Swiss IBD Cohort, No. 3347CO-108792; and by the Zurich Center for Integrative Human Physiology (ZIHP) of the University of Zurich
Correspondence to: Dr. Michael Scharl, MD, PhD, Division of Gastroenterology and Hepatology, University Hospital Zürich, Rämistrasse 100, 8091 Zürich, Switzerland. michael.scharl@usz.ch
Telephone: +41-44-2559519 Fax: +41-44-2559497
Received: December 9, 2013 Revised: April 4, 2014 Accepted: May 29, 2014 Published online: August 15, 2014 Processing time: 268 Days and 11.1 Hours
Core Tip
Core tip: Fistulae represent an important complication in Crohn’s disease (CD) patients. CD-associated fistulae originate from an epithelial defect due to destructive inflammation. Having undergone epithelial-to-mesenchymal transition (EMT), intestinal epithelial cells (IEC) penetrate into deeper layers of the gut wall causing further tissue damage finally forming connections to other organs or the body surface. EMT of IEC results in activation of matrix remodelling enzymes. Soluble mediators like TNF and IL-13 induce their own expression and expression of molecules associated with cell invasiveness. A better understanding of the pathophysiology of fistula formation is a prerequisite for developing more efficacious medical anti-fistula treatments.
