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The immune response in inflammatory bowel disease
1Division of Gastroenterology, Department of Medicine, The Mount Sinai School of Medicine, New York, New York 10029, USA.
The American Journal of Gastroenterology
|June 15, 2007
Summary
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, arises from complex genetic, environmental, and immune factors. Current therapies target inflammation, with newer biologic agents offering benefits but carrying potential long-term risks.
Area of Science:
- Gastroenterology
- Immunology
- Pathogenesis of Inflammatory Bowel Disease
Background:
- Ulcerative colitis (UC) and Crohn's disease (CD) are distinct forms of inflammatory bowel disease (IBD) with unique histologic and cytokine profiles.
- IBD pathogenesis is multifactorial, involving genetic predisposition, environmental triggers, and dysregulated immune responses.
- A key feature is an inappropriate mucosal immune response to gut microbiota, leading to cytokine imbalance and tissue damage.
Purpose of the Study:
- To review the current understanding of IBD pathogenesis.
- To discuss the evolution of IBD therapies.
- To highlight the benefits and potential limitations of novel IBD treatments.
Main Methods:
- Review of existing literature on IBD pathogenesis and treatment.
- Analysis of animal models of colitis and human immune responses.
- Examination of current and emerging pharmacologic agents for IBD.
Main Results:
- IBD results from a complex interplay of genetic, environmental, and immunologic factors.
- An inappropriate mucosal immune response leads to an imbalance of pro- and anti-inflammatory cytokines.
- Neutrophil and monocyte influx causes tissue damage through oxygen radicals and enzymes.
Conclusions:
- IBD therapy has advanced with improved understanding of disease mechanisms.
- Conventional therapies include aminosalicylates, azathioprine/6-mercaptopurine, and steroids.
- Biologics targeting cytokines like TNF-alpha offer clinical benefits but require monitoring for long-term toxicity and immunogenicity.
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