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特定原发性免疫缺陷病患者的炎症性肠病治疗。

The Treatment of Inflammatory Bowel Disease in Patients with Selected Primary Immunodeficiencies.

机构信息

Pediatric Gastroenterology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

J Clin Immunol. 2018 Jul;38(5):579-588. doi: 10.1007/s10875-018-0524-9. Epub 2018 Jun 29.

Abstract

The gastrointestinal tract is heavily populated with innate and adaptive immune cells that have an active role in preservation of mucosal homeostasis and prevention of inflammation. Inflammatory bowel diseases are thought to result from dysregulated immune function that is influenced by genetic background, environmental triggers, and microbiome changes. While most inflammatory bowel disease patients present in adolescent years or adulthood, in a minority of cases, the disease develops early in life, and in some of these young patients, a monogenic disease causing intestinal inflammation can be identified. Many of these conditions result from mutations in immune-mediated genes and can present with or without concomitant recurrent infections. In this review, we will discuss the treatment of patients with selected primary immunodeficiencies and inflammatory bowel diseases. We will focus on five conditions resulting from mutations in IL10/IL10 receptor, NADPH oxidase complex, XIAP, LRBA, and CTLA-4.

摘要

胃肠道中存在大量固有和适应性免疫细胞,它们在维持黏膜内稳态和预防炎症方面发挥着积极作用。炎症性肠病被认为是免疫功能失调的结果,这种失调受遗传背景、环境触发因素和微生物组变化的影响。虽然大多数炎症性肠病患者在青少年或成年期发病,但在少数情况下,疾病在生命早期就已发生,在这些年轻患者中,一些导致肠道炎症的单基因疾病可以被识别。这些疾病中的许多是由免疫介导基因的突变引起的,并且可以伴有或不伴有伴随的反复感染。在这篇综述中,我们将讨论治疗具有特定原发性免疫缺陷和炎症性肠病的患者。我们将重点讨论五种由 IL10/IL10 受体、NADPH 氧化酶复合物、XIAP、LRBA 和 CTLA-4 突变引起的疾病。

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