[Pathogenesis of chronic inflammatory bowel diseases].
Genetic predisposition, nutritional and environmental influences, intestinal pathogens, psychological stress, and disturbed intestinal barrier function have been accepted as important factors in the pathogenesis of chronic inflammatory bowel diseases. Uncontrolled reactions of T-cells and proinflammatoric cytokines are the common denominator of all factors contributing to pathogenesis. The detection of NOD2 gene mutation in about 25% of patients with Crohn's disease was an important step towards an understanding of the molecular background of the disease. The NOD2 proteins functions as an intracellular sensor of bacterial cell membrane constituents and is a crucial part of the innate immune system. In Crohn's disease, the secretion of defensins, naturally occurring antimicrobial peptides, is disturbed. There is evidence that several pathways involved in the reaction of the innate immune system may be disturbed in CED, ultimately leading to an uncontrolled activity of the adaptive immune system.
Kreisel
W
W
Abteilung Innere Medizin II, Medizinische Universitätsklinik Freiburg. kreisel@medizin.ukl.uni-freiburg.de
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000150:complications; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics / Q000276:immunology / Q000382:microbiology / Q000523:psychology / Q000628:therapy; D003424:Crohn Disease / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics / Q000276:immunology / Q000382:microbiology / Q000523:psychology / Q000628:therapy; D016207:Cytokines / Q000276:immunology; D023082:Defensins / Q000276:immunology / Q000378:metabolism; D020022:Genetic Predisposition to Disease; D006801:Humans; D007378:Interleukins / Q000276:immunology; D007422:Intestines / Q000382:microbiology / Q000502:physiology; D009154:Mutation; D053473:Nod2 Signaling Adaptor Protein / Q000235:genetics / Q000276:immunology; D019936:Probiotics / Q000627:therapeutic use; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology; D051193:Toll-Like Receptors
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D016207:Cytokines; D023082:Defensins; D007378:Interleukins; D053473:Nod2 Signaling Adaptor Protein; D051193:Toll-Like Receptors