Louis E, Van Kemseke C, Latour P, Belaiche J, Reenaers C
Service de Gastroentérologie, CHU de Liège, Belgique.
Rev Med Liege. 2012 May-Jun;67(5-6):298-304.
Inflammatory bowel diseases are both environmental and genetic illnesses. More than one hundred genes or loci involved in the regulation of innate or acquired immune response as well as intestinal mucosa homeostasis have been identified. Environmental studies have been less numerous up to now and only smoking and appendectomy have been validated, as protector for ulcerative colitis, while smoking is clearly associated with an increased risk and more severe forms of Crohn's disease. An important role is also currently suspected for the intestinal flora and the dysbiosis described in inflammatory bowel disease could contribute to the triggering or the persistence of the inflammation. New therapeutic strategies are currently studied, particularly aiming at targeting immune, inflammatory or homeostatic pathways corresponding to the predisposing gene variants.
炎症性肠病是环境因素和遗传因素共同导致的疾病。现已确定，有一百多个基因或基因座参与先天性或获得性免疫反应以及肠黏膜稳态的调节。到目前为止，环境因素的研究相对较少，仅有吸烟和阑尾切除术被证实对溃疡性结肠炎有保护作用，而吸烟显然与克罗恩病风险增加及病情更严重有关。目前还怀疑肠道菌群起着重要作用，炎症性肠病中描述的菌群失调可能促使炎症的触发或持续。目前正在研究新的治疗策略，特别是针对与易感基因变异相对应的免疫、炎症或稳态途径。
