School of Biomedical and Health Sciences, Kings College London, London, UK.
Eur J Gastroenterol Hepatol. 2009 Aug;21(8):843-9. doi: 10.1097/MEG.0b013e328318ecde.
Crohn's disease is suggested to result from a microbially triggered immune-mediated autoimmune process, involving mainly the terminal ileum and ileo-caecal junction. Klebsiella pneumoniae shares certain molecular structures present in pullulanase pulA and pulD secretion enzymes with various self-antigens present in collagens and HLA-B27 molecules, respectively. A link exists between high dietary starch intake and the growth of intestinal microflora, involving especially Klebsiella microbes. Increased exposure to Klebsiella in the gut as the result of high starch intake would lead to high production of antiKlebsiella antibodies as well as autoantibodies to the cross-reactive self-antigens with the resultant inflammation at the pathological sites. Eradication of these microbes from the gut in patients with Crohn's disease with the use of low-starch diet and antibacterial agents as well as immunomodulatory measures could be beneficial in the management of this disease.
克罗恩病被认为是由微生物触发的免疫介导的自身免疫过程引起的，主要涉及末端回肠和回盲肠交界处。肺炎克雷伯氏菌与各种胶原蛋白和 HLA-B27 分子中的自身抗原分别具有某些共同的分子结构，这些结构存在于普鲁兰酶 pulA 和 pulD 分泌酶中。高淀粉饮食与肠道微生物群的生长之间存在联系，特别是与克雷伯氏菌有关。由于高淀粉摄入，肠道中克雷伯氏菌的暴露增加会导致抗克雷伯氏菌抗体以及与交叉反应自身抗原的自身抗体的产生增加，从而导致病理部位的炎症。在克罗恩病患者中，通过使用低淀粉饮食、抗菌药物和免疫调节措施从肠道中消除这些微生物可能有助于这种疾病的治疗。
