Leprince E, André C, Descos L
Service d'Hépato-Gastroentérologie, Centre Hospitalier Lyon-Sud, Pierre-Bénite.
Presse Med. 1995;24(39):1902-6.
There is a body of clinical, epidemiological, biologic, histological and therapeutic data suggesting that type I hypersensitivity plays a role in the pathogenesis and maintenance of ulcerative colitis. Contradictory evidence from different studies on the pathogenic mechanisms may simply mean that there is not one but several types of ulcerative colitis. Chronic inflammation of the intestine would cover a heterogeneous group of conditions. Genetic susceptibility controlling one of more anomalies of the immune system would be triggered by external factors such as respiratory or food allergies, viral or bacterial infections or other factors including smoking or stress. The wide range of factors involved would explain the variety of findings reported by different groups searching for a single pathogenic mechanism. Finally, as emphasized by other authors, screening for subgroups of patients with allergy among the ulcerative colitis population would be useful in adapting treatment and developing a more specific therapeutic strategy not only for acute phases but perhaps also for preventive treatment.
有一系列临床、流行病学、生物学、组织学和治疗学数据表明,Ⅰ型超敏反应在溃疡性结肠炎的发病机制及维持过程中发挥作用。不同研究关于致病机制的相互矛盾的证据可能仅仅意味着溃疡性结肠炎并非只有一种类型,而是有多种类型。肠道的慢性炎症涵盖了一组异质性病症。控制免疫系统一个或多个异常的遗传易感性会由诸如呼吸道或食物过敏、病毒或细菌感染等外部因素,或包括吸烟或压力在内的其他因素引发。所涉及的众多因素可以解释不同研究组在寻找单一致病机制时所报告的各种研究结果。最后,正如其他作者所强调的,在溃疡性结肠炎患者群体中筛查过敏亚组患者,不仅对于急性期治疗,而且对于预防性治疗,在调整治疗方案及制定更具针对性的治疗策略方面都将是有用的。