Kellermayer Richard
Department of Pediatrics, Section of Pediatric Gastroenterology, Baylor College of Medicine, Texas Children's Hospital, USDA/ARS Children's Nutrition Research Center, Houston, Texas 77030-2399, USA.
Can J Gastroenterol. 2012 Dec;26(12):909-15. doi: 10.1155/2012/526408.
The gut microbiota, the intestinal mucosa and the host immune system are among the large biological networks involved in the development of inflammatory bowel disease (IBD), which includes Crohn disease (CD) and ulcerative colitis (UC). Host genetics and environmental factors can significantly modulate the interactive relationships among these biological systems and influence predilection toward IBD. High monozygotic twin discordance rates and the rapid rise in the prevalence of IBD indicate that environmental influences may be as important or even more important in their pathogenesis than genetic susceptibility. However, the nature and timing of environmental factors critical for inducing IBD remain largely unknown. The molecular mechanisms and the key biological component(s) that may be affected by such factors are also in question. Epigenetic changes, such as DNA methylation (the methylation of cytosines followed by a guanine in CpG dinucleotides) can be modified by environmental influences during finite developmental periods and have been implicated in the pathogenesis of IBD. Mucosal DNA methylation can also react to changes in the commensal microbiota, underscoring the intercalating relationships among the large biological systems involved in gastrointestinal disorders. Therefore, transient environmental influences during specific periods of development may induce critical change(s) in an isolated or concomitant fashion within the intestinal biomic networks and lead to increased susceptibility to IBD. The present review focuses on the emerging paradigm shift considering IBD to originate from critical environmental effects during pre- and postnatal development.
肠道微生物群、肠黏膜和宿主免疫系统是参与炎症性肠病(IBD)发生发展的大型生物网络的一部分,炎症性肠病包括克罗恩病(CD)和溃疡性结肠炎(UC)。宿主遗传学和环境因素可显著调节这些生物系统之间的相互作用关系,并影响患IBD的倾向。单卵双胞胎的高不一致率以及IBD患病率的迅速上升表明,在其发病机制中,环境影响可能与遗传易感性同样重要甚至更为重要。然而,对诱发IBD至关重要的环境因素的性质和时机仍 largely unknown。受这些因素影响的分子机制和关键生物成分也存在疑问。表观遗传变化,如DNA甲基化(CpG二核苷酸中胞嘧啶后接鸟嘌呤的甲基化),在有限的发育阶段可受环境影响而改变,并与IBD的发病机制有关。黏膜DNA甲基化也可对共生微生物群的变化做出反应,这突出了参与胃肠道疾病的大型生物系统之间的相互关系。因此,发育特定时期的短暂环境影响可能以孤立或伴随的方式在肠道生物组网络内引发关键变化,并导致对IBD的易感性增加。本综述重点关注了一种新出现的范式转变,即认为IBD起源于产前和产后发育期间的关键环境影响。