Aujnarain Amiirah, Mack David R, Benchimol Eric I
Department of Pediatrics, University of Ottawa, Ottawa, Canada.
Curr Gastroenterol Rep. 2013 Jun;15(6):326. doi: 10.1007/s11894-013-0326-4.
The incidence of inflammatory bowel disease (IBD) is rising worldwide, with a particularly sharp increase in children. Rates are highest in North America and Europe, with rapid increases noted in developing nations adopting the Westernized environment. While many genetic risk loci have been identified that predispose people to IBD, incomplete penetrance and overlapping genotypes among patients with different phenotypes inadequately explain the etiology of these chronic diseases. Therefore, environmental risk factors have been the subject of much recent research. This article reviews the role of the environment in IBD, with particular focus on early-life exposures and pediatric-onset disease. The literature surrounding environmental risk factors is reviewed, including prenatal and perinatal exposures, the hygiene hypothesis, the urban environment, infection and antibiotic use, and secondhand tobacco smoke exposure. In addition, the possible role of the environment in altering the intestinal microbiome is addressed.
炎症性肠病（IBD）在全球范围内的发病率正在上升，在儿童中上升尤为明显。北美和欧洲的发病率最高，在采用西方化环境的发展中国家也有快速增长。虽然已经确定了许多使人们易患IBD的遗传风险位点，但不同表型患者之间不完全的外显率和重叠的基因型并不能充分解释这些慢性病的病因。因此，环境风险因素成为近期许多研究的主题。本文综述了环境在IBD中的作用，特别关注生命早期暴露和儿童期发病的疾病。对围绕环境风险因素的文献进行了综述，包括产前和围产期暴露、卫生假说、城市环境、感染和抗生素使用以及二手烟暴露。此外，还探讨了环境在改变肠道微生物群方面的可能作用。
