Document Detail


Recent advances in the etiology and treatment of Crohn's disease.
MedLine Citation:
PMID:  20485257     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Significant advances have been achieved in the understanding of the pathogenesis of Crohn's disease (CD). A number of susceptibility genes have been detected by large genome wide screening-approaches. We do not completely understand the function of most of these genetic variants, however, there is good evidence that most of them are associated with the recognition and detection of luminal bacteria as well as defence against this microbiota. The important role of intestinal bacteria for the onset of CD is now clear. The intestinal bacteria and other "environmental" factors certainly contribute to CD pathogenesis: the respective genetic variations now termed as "susceptibility factors" exist since ten thousands of years. However, the incidence of CD is largely dependent on factors such as childhood hygiene or socioeconomic status; factors that are determined by living conditions and environment. New therapeutic concepts emerge from these insights. The most important progress in recent years certainly is the introduction of biologics in the therapy of CD. TNF blockers have been shown to be very effective for the control of complicated disease courses. However, more time will be needed until the concepts on pathogenesis evolve into new therapeutics that are introduced into clinical routine and guidelines. The hygiene hypothesis has led to the administration of helminths to CD patients to modulate the intestinal immune system. Another new approach is to improve the mucosal barrier function, which has been shown to be impaired in CD patients.
Authors:
S R Vavricka; G Rogler
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva gastroenterologica e dietologica     Volume:  56     ISSN:  1121-421X     ISO Abbreviation:  Minerva Gastroenterol Dietol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-20     Completed Date:  2010-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9109791     Medline TA:  Minerva Gastroenterol Dietol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  203-11     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital of Zürich, Zürich, Schwitzerland.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / therapeutic use
Crohn Disease / etiology*,  genetics,  microbiology,  therapy*
Drug Therapy, Combination
Gastrointestinal Agents / therapeutic use
Humans
Hygiene
Immunosuppressive Agents / therapeutic use
Incidence
Poverty
Risk Factors
Smoking / adverse effects
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Gastrointestinal Agents; 0/Immunosuppressive Agents; 0/Tumor Necrosis Factor-alpha

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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