Department of Medicine, Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029, USA.
Gastroenterology Unit, Lille University Nord de France, CHU Lille, 2 Avenue Oscar Lambret, Lille 59 000, France.
Nat Rev Gastroenterol Hepatol. 2014 Feb;11(2):88-98. doi: 10.1038/nrgastro.2013.240. Epub 2013 Dec 17.
IBD is a chronic disorder with disease onset ranging from early childhood to beyond the sixth decade of life. The factors that determine the age of onset currently remain unexplained. Is timing of occurrence a random event or is it indicative of different pathophysiological pathways leading to different phenotypes across the age spectrum? Over the past decade, several studies have suggested that the characteristics and natural history of IBD seem to be different according to age of onset. This heterogeneity suggests that the respective contributions of genetics, host immune system and environment to the aetiology and phenotype of Crohn's disease and ulcerative colitis are different across ages. Critical reviews that focus on differences characterizing IBD between age groups are scarce. Therefore, this Review updates the knowledge of the differences in epidemiology, clinical characteristics, and natural history of paediatric, adult and elderly-onset IBD. In addition, potential differences in host-gene-microbial interactions according to age are highlighted.
炎症性肠病（IBD）是一种慢性疾病，发病年龄范围从儿童早期到 60 多岁以后。目前，尚不清楚决定发病年龄的因素。发病时间是随机事件，还是提示不同的病理生理途径导致了不同的表型？在过去的十年中，多项研究表明，根据发病年龄，IBD 的特征和自然病史似乎有所不同。这种异质性表明，遗传、宿主免疫系统和环境对克罗恩病和溃疡性结肠炎的发病机制和表型的各自贡献在不同年龄段是不同的。专门关注不同年龄段 IBD 特征差异的关键性评论很少。因此，本综述更新了对儿童期、成人期和老年期 IBD 的流行病学、临床特征和自然病史差异的认识。此外，还强调了根据年龄不同，宿主-基因-微生物相互作用的潜在差异。
