Pouchitis: lessons for inflammatory bowel disease.
OBJECTIVE
One of the significant limitations to the investigation of inflammatory bowel disease (IBD) in humans is the impossibility of studying this condition from the beginning of the disease process to understand the individual contribution of the various microbiological and immunological components to its pathogenesis. Pouchitis can serve as a human model for IBD, as the time of the pouch creation is known, which allows to prospectively study the events that might eventually lead to the development of a form of intestinal inflammation (i.e., pouchitis) that mimics IBD.


RESULTS
A considerable amount of progress has been made in the last few years on the mechanisms underlying the pathogenesis of pouchitis. Recent literature suggests that pouchitis may present a spectrum of disease processes, with a wide range of causes, risk factors, clinical phenotypes, disease courses, and prognoses. Genetic, microbiological, and immunological profiles in pouchitis were evaluated.


CONCLUSIONS
Ileal pouch and pouchitis represent a valuable human model to study the evolution of bacterial communities and host-bacteria interactions in IBD by sequentially monitoring microbiological and immunological profile before, during, and after pouch construction and before and after development and treatment of pouchitis.
Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China.
Hao
H
Wu
Bo
B
Shen
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D039021:Colonic Pouches; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D008297:Male; D019449:Pouchitis / Q000276:immunology* / Q000382:microbiology* / Q000628:therapy*; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012086:Reoperation; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents