Stricture formation in Crohn's disease - The role of intestinal fibroblasts

Objective To determine whether intestinal fibroblasts in patients with Crohn's diseas e (CD) have an enhanced capacity to reorganize collagen and thus cause stri cture formation. Summary Background Data Stricture formation is a characteristic feature of CD that may distinguish it from other forms of inflammatory bowel disease. Methods Fibroblasts were obtained at surgery from the colon and ileum of patients w ith CD and ulcerative colitis (UC) and control patients. Primary fibroblast cultures were obtained by explant technique. Fibroblast contractile activi ty was measured using fibroblast-populated collagen lattices (FPCLs), in wh ich the cultured fibroblasts were seeded in free-floating collagen gel matr ices that they reorganize and contract. Fibroblast contractile activity was measured as the reduction of surface area (mm(2)) of collagen gel matrix a t 24-hour intervals for 1 week. Results Fibroblasts from patients with CD displayed enhanced capacity to contract F PCL when compared to UC and control fibroblasts. This activity was maximal in fibroblasts recovered from strictured regions in CD. Fibroblasts from pa tients with UC had a contractile capacity similar to that of controls. Hydr ocortisone inhibited this in vitro contractile activity in a dose-dependent manner. Conclusions Intestinal fibroblasts in CD possess enhanced capacity for collagen reorgan ization and contractile activity in vitro. This activity may be responsible for stricture formation in CD.