Pisani Laura Francesca, Tontini Gian Eugenio, Vecchi Maurizio, Pastorelli Luca
*Gastroenterology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; and †Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
Inflamm Bowel Dis. 2016 Feb;22(2):450-8. doi: 10.1097/MIB.0000000000000628.
Microscopic colitis (MC) is a common cause of chronic diarrhea. The 2 most frequent forms of MC are collagenous colitis and lymphocytic colitis. Over the past years, the incidence and prevalence of microscopic colitis are rising and this is largely attributed to a greater awareness, and concomitantly an increasing number of diagnoses. Patients with microscopic colitis report watery, nonbloody diarrhea of chronic course, abdominal pain, weight loss, and fatigue that may impair patient's health-related quality of life. The underlying mechanisms involved in the pathogenesis of microscopic colitis remain unspecified but is probably multifactorial. Collagenous colitis and lymphocytic colitis may represent specific mucosal responses to different luminal agents in predisposed individuals, resulting in an uncontrolled immune response. Genetic predisposition, altered modulation of cytokines and miRNAs, and aberrant response to drugs seem to be involved in the development of MC. Despite the progress of knowledge, still many questions remain unsolved regarding the etiology, pathophysiology, and optimal management of MC. This review gives an update on the immunological aspects of collagenous colitis and lymphocytic colitis.
显微镜下结肠炎（MC）是慢性腹泻的常见病因。MC最常见的两种形式是胶原性结肠炎和淋巴细胞性结肠炎。在过去几年中，显微镜下结肠炎的发病率和患病率呈上升趋势，这在很大程度上归因于人们的认识提高，随之而来的是诊断数量的增加。显微镜下结肠炎患者表现为慢性病程的水样、非血性腹泻、腹痛、体重减轻和疲劳，这些可能会损害患者的健康相关生活质量。显微镜下结肠炎发病机制所涉及的潜在机制尚不明确，但可能是多因素的。胶原性结肠炎和淋巴细胞性结肠炎可能代表了易感个体对不同腔内因素的特定黏膜反应，导致免疫反应失控。遗传易感性、细胞因子和微小RNA调节的改变以及对药物的异常反应似乎都与MC的发生发展有关。尽管知识有所进步，但关于MC的病因、病理生理学和最佳治疗仍有许多问题尚未解决。本综述对胶原性结肠炎和淋巴细胞性结肠炎的免疫学方面进行了更新。
