Department of Internal Medicine, Peterfy Hospital, Budapest, Hungary.
Pathol Oncol Res. 2011 Sep;17(3):463-72. doi: 10.1007/s12253-011-9397-4. Epub 2011 Jun 17.
The factors involved in the pathogenesis of Crohn's disease and ulcerative colitis, the two major types of inflammatory bowel disease (IBD) are summarized. Intestinal antigens composed of bacterial flora along with antigen presentation and impaired mucosal barrier have an important role in the initiation of IBD. The bacterial community may be modified by the use of antibiotics and probiotics. The dentritic cells recognize the antigens by cell surface Toll like receptor and the cytoplasmic CARD/NOD system. The balance between Th1/Th2/Th17 cell populations being the source of a variety of cytokines regulates the inflammatory mechanisms and the clearance of microbes. The intracellular killing and digestion, including autophagy, are important in the protection against microbes and their toxins. The homing process determines the location and distribution of the immune cells along the gut. All these players are potential targets of pharmacological manipulation of disease status.
总结了导致克罗恩病和溃疡性结肠炎（两种主要的炎症性肠病，IBD）发病的相关因素。肠道抗原由肠道菌群以及抗原呈递和受损的黏膜屏障组成，在 IBD 的发生中起重要作用。抗生素和益生菌的使用可能会改变肠道菌群。树突状细胞通过细胞表面 Toll 样受体和细胞质 CARD/NOD 系统识别抗原。Th1/Th2/Th17 细胞群之间的平衡是各种细胞因子的来源，调节炎症机制和微生物的清除。包括自噬在内的细胞内杀伤和消化在防止微生物及其毒素方面非常重要。归巢过程决定了免疫细胞在肠道中的位置和分布。所有这些参与者都是疾病状态药物治疗的潜在靶点。
