PathogenesisofCrohnsdisease:Bugornobug
摘要: Thepossibilityofaninfectiousoriginininflammatoryboweldisease(IBD)hasbeenpostulatedsincethefirstdescriptionofCrohn’sdisease(CD).ManyobservationsimplicatebacteriaasatriggerforthedevelopmentofCD:lesionsoccurinregionswithhigherbacterialconcentrations;aphthousulcersoccurinPeyer’spatches;inflammationresolveswhenthefecalstreamisdivertedandisreactivatedfollowingreinfusionofbowelcontents;severityofthediseaseiscorrelatedwithbacterialdensityinthemucosa;granulomascancontainbacteria;andsusceptiblemiceraisedingermfreeconditionsdevelopinflammationwhenbacteriaareintroducedinthe1990’s,severalstudiessoughttoestablisharelationshipwithviralinfectionsandtheonsetofIBD,finallyconcludingthatnodirectlinkhadbeendemonstrated.Inthepastfifteenyears,evidencerelatingIBDpathogenesistoMycobacteriumaviumparatuberculosis,salmonella,campylobacter,etc.,hasbeenfound.Thetendencynowunderdiscussiontoregardmicrobiotaastheprimarycatalysthasledtothelateststudiesonmicrobiotaaspathogens,focusingonEscherichiacoli,mainlyinilealCD.Thepresentreviewdiscussestheliteratureavailableonthesebugs. ...
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