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[免疫介导性肠道疾病发病机制理解中的里程碑。其诊断与治疗的演变]

[Milestones in understanding the pathogenesis of immunmediated intestinal disorders. Evolution of their diagnosis and therapy].

作者信息

Arató András

机构信息

Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest Bókay János u. 53. 1083.

出版信息

Orv Hetil. 2013 Sep 22;154(38):1512-23. doi: 10.1556/OH.2013.29710.

Abstract

In the last decades our knowledge has been enormously broadened about the structure and function of the gut associated lymphoid system. It was recognized how intricate and finely tuned connection exists between the gut bacterial flora and the intestinal mucosa. This subtle balance ensures mucosal homeostasis, which has a key role in organ defence against pathogens. However, at the same time this system makes possible the development of oral tolerance toward the commensals and the food antigens. In case of any disturbances in this finely tuned process, immunmediated intestinal disorders may easily develop. The first part of this paper reviews the structure and function of the mucosal immune system, while the second part surveys the pathogenesis, diagnosis and therapy of coeliac disease, inflammatory bowel disease and cow's milk allergy induced enteropathy.

摘要

在过去几十年里,我们对肠道相关淋巴系统的结构和功能的认识有了极大的拓展。人们认识到肠道细菌菌群与肠黏膜之间存在着多么复杂且精确调节的联系。这种微妙的平衡确保了黏膜的稳态,而黏膜稳态在机体抵御病原体方面起着关键作用。然而,与此同时,这个系统也使得对共生菌和食物抗原产生口服耐受性成为可能。如果这个精细调节的过程出现任何干扰,免疫介导的肠道疾病可能很容易就会发生。本文的第一部分回顾了黏膜免疫系统的结构和功能,而第二部分则概述了乳糜泻、炎症性肠病和牛奶过敏诱发的肠病的发病机制、诊断和治疗。

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