AVANÇOS NA COMPREENSÃO DA DOENÇA DE CROHN: MECANISMOS DE FIBROSE, BIOMARCADORES E PERSPECTIVAS TERAPÊUTICAS

Crohn’s disease (CD) is a chronic inflammatory bowel disease characterized by transmural inflammation and immunological impairment. This study reviews immune dysregulation as a central factor in the pathogenesis of CD and analyzes immunomodulatory interventions, such as immunosuppressants and biological therapies, in comparison with conventional treatments or placebo. The research used the integrative review methodology, guided by the PICO strategy. Studies published between 2019 and 2024, identified in the PubMed database, were included. The inclusion criteria covered studies on CD focusing on immune dysregulation and therapeutic interventions, while the exclusion criteria disregarded articles that did not present original or relevant data on the topic. The results indicated that the immune response in CD is mediated by pro-inflammatory cytokines (such as TNF-α, IL-17 and IL-21), which perpetuate intestinal inflammation and contribute to complications such as fibrosis and strictures. Biological and immunosuppressive therapies have demonstrated efficacy in reducing inflammatory outbreaks, improving quality of life, and decreasing complication rates when compared to conventional treatments. It is concluded that a detailed understanding of the immunological mechanisms of CD allows the development of more targeted and effective therapies. Despite advances, challenges remain, such as the management of therapeutic resistance and the identification of biomarkers that allow early diagnosis and accurate monitoring of the disease. These findings reinforce the importance of the immunological approach in the treatment and clinical management of Crohn’s disease.