Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.), University of Palermo, 90127 Palermo, Italy.
Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, via del Vespro 129, 90127 Palermo, Italy.
Cells. 2022 Jan 28;11(3):455. doi: 10.3390/cells11030455.
Inflammatory bowel disease (IBD) is an increasingly urgent medical problem that strongly impairs quality of life for patients. A global rise in incidence has been observed over the last few decades, with the highest incidence rates recorded in North America and Europe. Still, an increased incidence has been reported in the last ten years in newly industrialized countries in Asia, including China and India, both with more than one billion inhabitants. These data underline that IBD is an urgent global health problem. In addition, it is estimated that between 20% and 30% of IBD patients will develop colorectal cancer (CRC) within their lifetime and CRC mortality is approximately 50% amongst IBD patients. Although the exact etiology of IBD is still being defined, it is thought to be due to a complex interaction between many factors, including defects in the innate and adaptive immune system; microbial dysbiosis, i.e., abnormal levels of, or abnormal response to, the gastrointestinal microbiome; a genetic predisposition; and several environmental factors. At present, however, it is not fully understood which of these factors are the initiators of inflammation and which are compounders. The purpose of this review is to analyze the complex balance that exists between these elements to maintain intestinal homeostasis and prevent IBD or limit adverse effects on people's health.
炎症性肠病（IBD）是一个日益紧迫的医学问题，它严重影响了患者的生活质量。在过去几十年中，全球发病率呈上升趋势，发病率最高的地区为北美和欧洲。尽管如此，在过去十年中，包括中国和印度在内的亚洲新兴工业化国家的发病率也有所上升，这两个国家的人口都超过了 10 亿。这些数据强调了 IBD 是一个紧迫的全球健康问题。此外，据估计，IBD 患者中有 20%至 30%会在其一生中发展为结直肠癌（CRC），而 IBD 患者的 CRC 死亡率约为 50%。尽管 IBD 的确切病因仍在定义中，但据认为是由于许多因素的复杂相互作用引起的，包括先天和适应性免疫系统的缺陷；微生物失调，即胃肠道微生物组的水平异常或对其异常反应；遗传易感性；以及几种环境因素。然而，目前尚不完全清楚这些因素中哪些是炎症的启动因素，哪些是加重因素。本文的目的是分析维持肠道内稳态和预防 IBD 或限制对人们健康的不利影响所需的这些因素之间存在的复杂平衡。
