环境(暴露体)在炎症性肠病中的作用?

Carlotta Zennaro
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摘要

第17届欧洲克罗恩病和结肠炎组织(ECCO)大会开幕第二天,英国伦敦巴特健康NHS信托基金会炎症性肠病教授James Lindsay和英国伦敦玛丽女王大学伦敦医学院讨论了环境对发展炎症性肠病(IBD)风险的影响。该报告讨论了介导环境对IBD影响的途径以及目前可用研究的局限性,为未来的研究提供了有价值的见解,以最终确定环境因素在IBD中的作用。IBD是一种炎症性疾病,包括克罗恩病(CD)和溃疡性结肠炎(UC),目前对IBD的理解是,这种疾病是由遗传易感个体对肠道菌群微生物的免疫反应引起的。除了疾病的发病机制外,其他重要的方面,如进展、肠外表现和对治疗的免疫原性,尚未得到很好的理解。虽然遗传学基础是明确的,但它并不能解释同卵双胞胎的疾病不一致,第二代移民的发病率增加,或者过去50年来IBD病例的快速增加。根据这些观察结果,Lindsay表达了检查环境作用的重要性,他强调,环境不是由单一因素组成的,而是由许多因素组成的,这些因素可能影响疾病的发病和自然历史。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What Is the Role of the Environment (Exposome) in Inflammatory Bowel Disease?
OPENING Day 2 of the 17th Congress of European Crohn’s and Colitis Organisation (ECCO), James Lindsay, Professor of Inflammatory Bowel Disease, Barts Health NHS Trust, London, UK, and The London School of Medicine, Queen Mary University of London, UK, discussed the influence of the environment on the risk of developing inflammatory bowel disease (IBD). The presentation discussed the pathways that mediate environmental impact on IBD as well as the limitations of presently available research, giving a valuable insight into what future studies could be conducted to ultimately determine the role of environmental factors in IBD. The present understanding of IBD, an inflammatory disease, which includes Crohn’s disease (CD) and ulcerative colitis (UC), is that the condition arises from an immune response to micro-organisms of the intestinal flora in genetically susceptible individuals. In addition to disease pathogenesis, other important aspects such as progression, extraintestinal manifestations, and immunogenicity to therapies, are yet to be well understood. While the genetics base is clear, it does not account for the discordance of disease in monozygotic twins, the increased incidence in second generation immigrants, or the rapid increase in IBD cases in the last 50 years. In light of these observations, Lindsay expressed the importance of examining the role of the environment, which, he stressed, does not comprise a single factor, but a multitude of factors that are likely to impact disease onset and natural history.
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