Sahami S, Kooij I A, Meijer S L, Van den Brink G R, Buskens C J, Te Velde A A
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands.
Am J Gastroenterol. 2016 Feb;111(2):163-9. doi: 10.1038/ajg.2015.301. Epub 2015 Sep 29.
The human appendix has long been considered as a vestigial organ, an organ that has lost its function during evolution. In recent years, however, reports have emerged that link the appendix to numerous immunological functions in humans. Evidence has been presented for an important role of the appendix in maintaining intestinal health. This theory suggests that the appendix may be a reservoir or 'safe house' from which the commensal gut flora can rapidly be reestablished if it is eradicated from the colon. However, the appendix may also have a role in the development of inflammatory bowel disease (IBD). Several large epidemiological cohort studies have demonstrated the preventive effect of appendectomy on the development of ulcerative colitis, a finding that has been confirmed in murine colitis models. In addition, current studies are examining the possible therapeutic effect of an appendectomy to modulate disease course in patients with ulcerative colitis. This literature review assesses the current knowledge about the clinical and immunological aspects of the vermiform appendix in IBD and suggests that the idea of the appendix as a vestigial remnant should be discarded.
长期以来，人类阑尾一直被视为退化器官，即一种在进化过程中失去功能的器官。然而近年来，有报告称阑尾与人类的多种免疫功能有关。已有证据表明阑尾在维持肠道健康方面发挥着重要作用。该理论认为，阑尾可能是一个储存库或“安全屋”，如果共生肠道菌群从结肠中被根除，阑尾可以使其迅速重新建立。然而，阑尾在炎症性肠病（IBD）的发展中可能也起作用。几项大型流行病学队列研究已证明阑尾切除术对溃疡性结肠炎发展具有预防作用，这一发现已在小鼠结肠炎模型中得到证实。此外，目前的研究正在探讨阑尾切除术对调节溃疡性结肠炎患者病程的可能治疗效果。这篇文献综述评估了目前关于IBD中阑尾的临床和免疫学方面的知识，并建议摒弃将阑尾视为退化残余物的观点。
