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Mechanisms of Pediatric Inflammatory Bowel Disease
Joanna M Peloquin1,2,3, Gautam Goel2,3, Eduardo J Villablanca1,2,3
1Gastrointestinal Unit and Center for the Study of Inflammatory Bowel Disease and.
Insights
Pediatric inflammatory bowel disease (IBD) is rising, especially in young children. This review covers IBD causes, clinical signs, and environmental factors, focusing on genetic risks and future therapeutic targets.
Area of Science:
- Gastroenterology and immunology
- Pediatric medicine
- Genetics and environmental health
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn disease and ulcerative colitis, involves chronic intestinal inflammation.
- The incidence of pediatric IBD is increasing, particularly in children under 10 years old.
- IBD pathogenesis stems from a complex interplay of genetic factors, mucosal barrier dysfunction, immune dysregulation, and environmental influences.
Purpose of the Study:
- To review the clinical presentation of pediatric IBD patients.
- To highlight environmental exposures contributing to IBD risk, especially in genetically predisposed individuals.
- To discuss advancements in understanding the intestinal epithelium, immune system, and microbiota in IBD.
Main Methods:
- Literature review of IBD pathogenesis, clinical presentation, and risk factors.
- Analysis of genetic determinants, environmental triggers, and their interaction.
- Examination of the roles of the intestinal epithelium, mucosal immunity, and microbiota.
Main Results:
- Pediatric IBD incidence is rising, with specific environmental exposures identified as potential risk factors.
- Dysfunction in the intestinal epithelium, mucosal immune system, or microbiota can lead to IBD.
- Genetic predisposition interacts with environmental factors to influence IBD development.
Conclusions:
- Understanding IBD pathogenesis requires integrating genetic and environmental factors.
- Advances in IBD genetics offer potential for developing targeted therapeutics.
- Future research should focus on key pathogenic nodes for novel treatment strategies.
Abstract:
Inflammatory bowel disease (IBD), including Crohn disease and ulcerative colitis, is characterized by chronic intestinal inflammation due to a complex interaction of genetic determinants, disruption of mucosal barriers, aberrant inflammatory signals, loss of tolerance, and environmental triggers. Importantly, the incidence of pediatric IBD is rising, particularly in children younger than 10 years. In this review, we discuss the clinical presentation of these patients and highlight environmental exposures that may affect disease risk, particularly among people with a background genetic risk. With regard to both children and adults, we review advancements in understanding the intestinal epithelium, the mucosal immune system, and the resident microbiota, describing how dysfunction at any level can lead to diseases like IBD. We conclude with future directions for applying advances in IBD genetics to better understand pathogenesis and develop therapeutics targeting key pathogenic nodes.
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