Inflammatory bowel disease in children.
Inflammatory bowel disease in children and adults remains the most challenging problem in gastroenterology. There is an increasing body of immunologic and genetic evidence to suggest that Crohn's disease and ulcerative colitis are different diseases, but that once inflammation begins, many common secondary pathways of inflammation are initiated. The major recent conceptual advance is the observation that mice in whom different immunoregulatory pathways are disrupted develop an inflammatory bowel disease. In the case of interleukin-2 knockout mice, the lesion restricted to the colon, is virtually identical to ulcerative colitis in humans, and is initiated by the normal bacterial flora. Yet these mice possess anticolon antibodies, long-considered to be of pathologic significance in ulcerative colitis. These animal models will allow detailed longitudinal studies to be done, and less reliance will need to be placed on cross-sectional studies of chronically inflamed gut from patients.
MacDonald
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Department of Paediatric Gastroenterology, Medical College of St. Bartholomew's Hospital, West Smithfield, London, UK.
D000367:Age Factors; D000818:Animals; D002648:Child; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000276:immunology; D004195:Disease Models, Animal; D004750:Enteral Nutrition; D006130:Growth Disorders / Q000209:etiology; D006801:Humans; D007165:Immunosuppression Therapy; D015212:Inflammatory Bowel Diseases / Q000145:classification / Q000209:etiology / Q000235:genetics / Q000276:immunology / Q000628:therapy; D008137:Longitudinal Studies; D051379:Mice; D018345:Mice, Knockout
D016207:Cytokines