title: Immunopathogenesis of IBD: current state of the art.
abstract: IBD is a chronic inflammatory condition of the gastrointestinal tract encompassing two main clinical entities: Crohn's disease and ulcerative colitis. Although Crohn's disease and ulcerative colitis have historically been studied together because they share common features (such as symptoms, structural damage and therapy), it is now clear that they represent two distinct pathophysiological entities. Both Crohn's disease and ulcerative colitis are associated with multiple pathogenic factors including environmental changes, an array of susceptibility gene variants, a qualitatively and quantitatively abnormal gut microbiota and a broadly dysregulated immune response. In spite of this realization and the identification of seemingly pertinent environmental, genetic, microbial and immune factors, a full understanding of IBD pathogenesis is still out of reach and, consequently, treatment is far from optimal. An important reason for this unsatisfactory situation is the currently limited comprehension of what are the truly relevant components of IBD immunopathogenesis. This article will comprehensively review current knowledge of the classic immune components and will expand the concept of IBD immunopathogenesis to include various cells, mediators and pathways that have not been traditionally associated with disease mechanisms, but that profoundly affect the overall intestinal inflammatory process.
authors.affiliation: Department of Gastroenterology &Multidisciplinary Research Laboratory, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
authors.forename: Heitor S P
authors.initials: HS
authors.lastname: de Souza
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Claudio
authors.initials: C
authors.lastname: Fiocchi
mesh_terms: D056704:Adaptive Immunity / Q000276:immunology; D000328:Adult; D000067531:Alarmins / Q000235:genetics / Q000502:physiology; D015984:Causality; D002648:Child; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000276:immunology*; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000276:immunology*; D003468:Cultural Evolution; D005786:Gene Expression Regulation / Q000235:genetics; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology; D058847:Inflammasomes / Q000276:immunology; D035683:MicroRNAs / Q000235:genetics; D064307:Microbiota / Q000276:immunology; D038621:Regulatory Sequences, Ribonucleic Acid / Q000235:genetics
chemical_list: D000067531:Alarmins; D058847:Inflammasomes; D035683:MicroRNAs; D038621:Regulatory Sequences, Ribonucleic Acid