克罗恩病：演变、表观遗传学以及微生物群靶向疗法的新作用
Crohn's Disease: Evolution, Epigenetics, and the Emerging Role of Microbiome-Targeted Therapies.
作者信息
DeFilippis Ersilia M, Longman Randy, Harbus Michael, Dannenberg Kyle, Scherl Ellen J
机构信息
Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02120, USA.
Jill Roberts Center for Inflammatory Bowel Disease, Jill Roberts Institute for Research in Inflammatory Bowel Disease, New York Presbyterian Hospital-Weill Cornell Medical College, 1315 York Avenue, Mezzanine Level, New York, NY, 10065, USA.
出版信息
Curr Gastroenterol Rep. 2016 Mar;18(3):13. doi: 10.1007/s11894-016-0487-z.
Crohn's disease (CD) is a chronic, systemic, immune-mediated inflammation of the gastrointestinal tract. Originally described in 1932 as non-caseating granulomatous inflammation limited to the terminal ileum, it is now recognized as an expanding group of heterogeneous diseases defined by intestinal location, extent, behavior, and systemic extraintestinal manifestations. Joint diseases, including inflammatory spondyloarthritis and ankylosing spondylitis, are the most common extraintestinal manifestations of CD and share more genetic susceptibility loci than any other inflammatory bowel disease (IBD) trait. The high frequency and overlap with genes associated with infectious diseases, specifically Mendelian susceptibility to mycobacterial diseases (MSMD), suggest that CD may represent an evolutionary adaptation to environmental microbes. Elucidating the diversity of the enteric microbiota and the protean mucosal immune responses in individuals may personalize microbiome-targeted therapies and molecular classifications of CD. This review will focus on CD's natural history and therapies in the context of epigenetics, immunogenetics, and the microbiome.
克罗恩病（CD）是一种慢性、全身性、免疫介导的胃肠道炎症。该病最初于1932年被描述为局限于回肠末端的非干酪样肉芽肿性炎症，现在被认为是一组不断扩大的异质性疾病，由肠道部位、范围、行为及全身性肠外表现所定义。关节疾病，包括炎性脊柱关节炎和强直性脊柱炎，是CD最常见的肠外表现，且与其他任何炎症性肠病（IBD）特征相比，共享更多的遗传易感性位点。其高频率以及与传染病相关基因（特别是孟德尔遗传性分枝杆菌病易感性，MSMD）的重叠，提示CD可能代表了对环境微生物的一种进化适应。阐明个体肠道微生物群的多样性和多变的黏膜免疫反应，可能使针对微生物群的疗法及CD的分子分类实现个体化。本综述将在表观遗传学、免疫遗传学和微生物群的背景下，重点关注CD的自然史和治疗方法。
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