Inflammatory bowel disease: Pathogenesis
Inflammatory bowel disease: Pathogenesis
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炎症性肠病：发病机制
DOI：
10.3748/wjg.v20.i1.91
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发表时间：
2014-01-07
影响因子：
4.3
通讯作者：
Li, Yong-Yu
中科院分区：
文献类型：
--
作者：
Zhang, Yi-Zhen;Li, Yong-Yu
炎症性肠病（IBD），包括克罗恩病和溃疡性结肠炎，其特征在于慢性复发性肠道炎症。它已成为一个全球性的卫生保健问题，发病率不断上升。据认为，IBD是由个体的遗传易感性催化的对肠道中微生物的异常和持续的免疫应答引起的。虽然IBD的病因学在很大程度上仍不清楚，但它涉及遗传、环境或微生物因素与免疫应答之间的复杂相互作用。在IBD发病机制的四个组成部分中，肠道炎症的遗传学研究进展最快。最新的国际合作研究已经确定了163个IBD易感基因位点。与儿童期发病和成人期发病IBD相关的基因重叠，提示有相似的遗传易感性。然而，遗传因素仅占总疾病变异的一部分的事实表明，微生物和环境因素可能与IBD发病机制中的遗传因素相互作用。与此同时，适应性免疫反应已被经典地认为在IBD的发病机制中起主要作用，因为免疫学和遗传学的新研究已经阐明先天免疫反应在诱导肠道炎症中保持相同的重要性。IBD发病机制的最新进展揭示了相关的疾病机制，包括先天性和适应性免疫，以及遗传因素与微生物和环境因素之间的相互作用。在这篇综述中，我们提供了在上述领域取得的主要进展的最新情况。(C)2014百世登出版集团有限公司有限公司All rights reserved.
Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is characterized by chronic relapsing intestinal inflammation. It has been a worldwide health-care problem with a continually increasing incidence. It is thought that IBD results from an aberrant and continuing immune response to the microbes in the gut, catalyzed by the genetic susceptibility of the individual. Although the etiology of IBD remains largely unknown, it involves a complex interaction between the genetic, environmental or microbial factors and the immune responses. Of the four components of IBD pathogenesis, most rapid progress has been made in the genetic study of gut inflammation. The latest internationally collaborative studies have ascertained 163 susceptibility gene loci for IBD. The genes implicated in childhood-onset and adult-onset IBD overlap, suggesting similar genetic predispositions. However, the fact that genetic factors account for only a portion of overall disease variance indicates that microbial and environmental factors may interact with genetic elements in the pathogenesis of IBD. Meanwhile, the adaptive immune response has been classically considered to play a major role in the pathogenesis of IBD, as new studies in immunology and genetics have clarified that the innate immune response maintains the same importance in inducing gut inflammation. Recent progress in understanding IBD pathogenesis sheds lights on relevant disease mechanisms, including the innate and adaptive immunity, and the interactions between genetic factors and microbial and environmental cues. In this review, we provide an update on the major advances that have occurred in above areas. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.