INUSpheresis® for Crohn's disease

Crohn's disease is an inflammatory bowel disease that primarily affects the mucosa of the distal ileum (lower section of the small intestine) and the colon (large intestine). Less commonly, the esophagus (food pipe) and oral area may also be affected. Typically, Crohn's disease occurs in young adults and begins with nonspecific symptoms such as weight loss, lower abdominal pain, fatigue and diarrhea.
Diarrhea is often crampy and painful and may occur several times a day. Other possible symptoms include fever, nausea, vomiting, skin rashes, painful ulcers and aphthae in the mouth. Crohn's disease can also affect other organs such as joints, eyes, blood vessels, kidneys, liver and bile ducts.

Similar to ulcerative colitis, symptoms of Crohn's disease can occur and subside in episodes. However, due to the chronic or intermittent inflammation, complications such as bowel obstruction, intestinal bleeding, or peritoneal abscesses may also occur. The disease course of Crohn's disease is classified into different stages based on the Crohn's Disease Activity Index (CDAI). A CDAI value above 150 indicates a relapse requiring treatment.

In general, inflammation in the small intestine leads to impaired absorption of vital nutrients. The exact causes of Crohn's disease are not yet clearly understood. It is suspected that problems in the immune system lead to excessive inflammatory reactions. The familial occurrence of the disease also suggests a genetic predisposition.

According to recent theories, it is a complex barrier disorder in which the barrier function of the inner and outer epithelial layers is disrupted. The mucus layers contain antimicrobial peptides, also called defensins.

In Crohn's disease, it is assumed that the formation of defensins is disturbed. Together with other factors, this leads to changes in the colonization of microorganisms and the invasion of bacteria, which triggers local inflammation.