Sands Bruce E
MGH Crohn's and Colitis Center and Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, 9th Floor, Boston, MA 02114, USA.
J Gastroenterol. 2007 Jan;42(1):16-25. doi: 10.1007/s00535-006-1995-7. Epub 2007 Feb 16.
Crohn's disease and ulcerative colitis, collectively known as the inflammatory bowel diseases (IBD), are largely diseases of the twentieth century, and are associated with the rise of modern, Westernized industrial society. Although the causes of these diseases remain incompletely understood, the prevailing model is that the intestinal flora drives an unmitigated intestinal immune response and inflammation in the genetically susceptible host. A review of the past and present of these diseases shows that detailed description preceded more fundamental elucidation of the disease processes. Working out the details of disease pathogenesis, in turn, has yielded dividends in more focused and effective therapy for IBD. This article highlights the key descriptions of the past, and the pivotal findings of current studies in disease pathogenesis and its connection to medical therapy. Future directions in the IBD will likely explicate the inhomogeneous causes of these diseases, with implications for individualized therapy.
克罗恩病和溃疡性结肠炎统称为炎症性肠病（IBD），它们在很大程度上是20世纪出现的疾病，与现代西方化工业社会的兴起有关。尽管这些疾病的病因仍未完全明确，但普遍的模型认为，肠道菌群在基因易感宿主中引发了不受控制的肠道免疫反应和炎症。回顾这些疾病的过去和现在可以发现，在对疾病过程进行更深入的阐释之前，已经有了详细的描述。反过来，弄清楚疾病发病机制的细节，也为IBD更有针对性和更有效的治疗带来了好处。本文重点介绍了过去的关键描述，以及当前疾病发病机制研究的关键发现及其与医学治疗的联系。IBD的未来发展方向可能会阐明这些疾病的多种病因，这对个体化治疗具有重要意义。
