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遗传学在理解炎症性肠病方面对新观点的贡献。

Contribution of genetics to a new vision in the understanding of inflammatory bowel disease.

作者信息

Peña A S

机构信息

VU University Medical Centre, Head, Department of Gastroenterology, 1007 MB Amsterdam, The Netherlands.

出版信息

World J Gastroenterol. 2006 Aug 14;12(30):4784-7. doi: 10.3748/wjg.v12.i30.4784.

Abstract

Inflammatory bowel diseases (IBD), such as Crohn's disease (CD) and ulcerative colitis (UC), are chronic inflammatory autoimmune conditions of the gastrointestinal tract. Other organs, such as the eyes, skin and articulations, are often affected and IBD may be accompanied by other diseases of autoimmune origin. There is no single etiological factor responsible for the onset of IBD. Recent advances in genetics and in the molecular mechanisms of the proteins coded by these genes have given rise to a new vision in understanding these complex diseases. Activation of specific genes that affect antigen presentation and the handling of cells by innate immunity may lead to autoimmunity with the consequent activation of the major histocompatibility complex (MHC) and multiple cytokines involved in the regulation of acquired immunity. In this review IBD is described as a constellation of diseases that can best be classified as barrier diseases. This vision, developed by Kiel in Germany, includes the idea that changes in our environment due to the westernization of civilization have not been met with adaptation of the innate immune system, and this has given rise to autoimmune diseases. These diseases affect 1-5 of 1000 individuals and represent a major burden on the national health systems of many countries on different continents. On a world scale, a major challenge is to generate interventions to prevent the development of these diseases in Asia, Latin America and Africa.

摘要

炎症性肠病(IBD),如克罗恩病(CD)和溃疡性结肠炎(UC),是胃肠道的慢性炎症性自身免疫性疾病。眼睛、皮肤和关节等其他器官也常受影响,且IBD可能伴有其他自身免疫性起源的疾病。IBD的发病不存在单一病因。遗传学以及这些基因所编码蛋白质的分子机制方面的最新进展,为理解这些复杂疾病带来了新的视角。影响抗原呈递以及天然免疫对细胞处理的特定基因的激活,可能导致自身免疫,进而激活主要组织相容性复合体(MHC)以及参与获得性免疫调节的多种细胞因子。在本综述中,IBD被描述为一类最好归类为屏障疾病的疾病群。德国基尔提出的这一观点认为,由于文明的西方化导致的环境变化,未被天然免疫系统所适应,从而引发了自身免疫性疾病。这些疾病影响着千分之一至千分之五的人群,给不同大陆上许多国家的国家卫生系统带来了沉重负担。在全球范围内,一个重大挑战是制定干预措施,以预防亚洲、拉丁美洲和非洲这些疾病的发生。

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