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Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
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Scleritis: Immunopathogenesis and molecular basis for therapy.

Denis Wakefield1, Nick Di Girolamo, Stephan Thurau

  • 1School of Medical Sciences, UNSW Medicine, University of New South Wales, Sydney, NSW 2052, Australia. d.wakefield@unsw.edu.au

Progress in Retinal and Eye Research
|March 5, 2013
PubMed
Summary

Scleritis, an autoimmune eye disease, involves scleral inflammation. Advances reveal T and B cell roles, leading to effective treatments like steroids and anti-TNF/B cell therapies for this potentially blinding condition.

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Area of Science:

  • Ophthalmology
  • Immunology
  • Rheumatology

Background:

  • Scleritis is a severe, potentially blinding inflammation of the sclera.
  • It can stem from infections or immune-mediated processes.
  • Recent research has significantly advanced understanding of its pathogenesis and treatment.

Purpose of the Study:

  • To review the progress in understanding scleritis pathogenesis and treatment.
  • To highlight the autoimmune nature of non-infectious scleritis.
  • To discuss the role of immune cells and cytokines in scleritis.

Main Methods:

  • Review of immunological investigations in non-infectious scleritis.
  • Analysis of studies on local inflammatory responses.
  • Evaluation of clinical trials for scleritis treatments.
  • Assessment of imaging and antibody testing in scleritis diagnosis.

Main Results:

  • Scleritis is confirmed as an autoimmune disease.
  • T and B cells, along with cytokines like TNF-alpha, play a key role in inflammation.
  • Steroid treatment, anti-TNF, and anti-B cell therapies show effectiveness.
  • Posterior scleritis is more common than previously thought.
  • ANCA antibodies indicate immune mechanisms in vasculitis-associated scleritis.

Conclusions:

  • Scleritis management has improved due to a better understanding of its autoimmune basis.
  • Targeted immunotherapies (anti-TNF, anti-B cell) are effective treatments.
  • Advanced diagnostics like imaging and antibody testing are crucial for comprehensive patient care.