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Making sense of the cause of Crohn’s – a new look at an old disease

The cause of Crohn’s disease (CD) has posed a conundrum for at least a century. A large body of work coupled with recent technological advances in genome research have at last started to provide some of the answers. Initially this review seeks to explain and to differentiate between bowel inflammati...

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Detalles Bibliográficos
Autor principal: Segal, Anthony W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000Research 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224693/
https://www.ncbi.nlm.nih.gov/pubmed/28105308
http://dx.doi.org/10.12688/f1000research.9699.2
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author Segal, Anthony W.
author_facet Segal, Anthony W.
author_sort Segal, Anthony W.
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description The cause of Crohn’s disease (CD) has posed a conundrum for at least a century. A large body of work coupled with recent technological advances in genome research have at last started to provide some of the answers. Initially this review seeks to explain and to differentiate between bowel inflammation in the primary immunodeficiencies that generally lead to very early onset diffuse bowel inflammation in humans and in animal models, and the real syndrome of CD. In the latter, a trigger, almost certainly enteric infection by one of a multitude of organisms, allows the faeces access to the tissues, at which stage the response of individuals predisposed to CD is abnormal. Direct investigation of patients’ inflammatory response together with genome-wide association studies (GWAS) and DNA sequencing indicate that in CD the failure of acute inflammation and the clearance of bacteria from the tissues, and from within cells, is defective. The retained faecal products result in the characteristic chronic granulomatous inflammation and adaptive immune response. In this review I will examine the contemporary evidence that has led to this understanding, and look for explanations for the recent dramatic increase in the incidence of this disease.
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spelling pubmed-52246932017-01-18 Making sense of the cause of Crohn’s – a new look at an old disease Segal, Anthony W. F1000Res Review The cause of Crohn’s disease (CD) has posed a conundrum for at least a century. A large body of work coupled with recent technological advances in genome research have at last started to provide some of the answers. Initially this review seeks to explain and to differentiate between bowel inflammation in the primary immunodeficiencies that generally lead to very early onset diffuse bowel inflammation in humans and in animal models, and the real syndrome of CD. In the latter, a trigger, almost certainly enteric infection by one of a multitude of organisms, allows the faeces access to the tissues, at which stage the response of individuals predisposed to CD is abnormal. Direct investigation of patients’ inflammatory response together with genome-wide association studies (GWAS) and DNA sequencing indicate that in CD the failure of acute inflammation and the clearance of bacteria from the tissues, and from within cells, is defective. The retained faecal products result in the characteristic chronic granulomatous inflammation and adaptive immune response. In this review I will examine the contemporary evidence that has led to this understanding, and look for explanations for the recent dramatic increase in the incidence of this disease. F1000Research 2016-11-16 /pmc/articles/PMC5224693/ /pubmed/28105308 http://dx.doi.org/10.12688/f1000research.9699.2 Text en Copyright: © 2016 Segal AW http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Segal, Anthony W.
Making sense of the cause of Crohn’s – a new look at an old disease
title Making sense of the cause of Crohn’s – a new look at an old disease
title_full Making sense of the cause of Crohn’s – a new look at an old disease
title_fullStr Making sense of the cause of Crohn’s – a new look at an old disease
title_full_unstemmed Making sense of the cause of Crohn’s – a new look at an old disease
title_short Making sense of the cause of Crohn’s – a new look at an old disease
title_sort making sense of the cause of crohn’s – a new look at an old disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224693/
https://www.ncbi.nlm.nih.gov/pubmed/28105308
http://dx.doi.org/10.12688/f1000research.9699.2
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