Literature DB >> 23946890

Why is damage limited to the mucosa in ulcerative colitis but transmural in Crohn's disease?

Xiaofa Qin1.   

Abstract

It has been a big puzzle as why the inflammation of ulcerative colitis (UC) is limited to the mucosa, while in Crohn's disease (CD) the inflammation is transmural and can be seen in all layers of the gut. Here, I give a tentative explanation extended from the unified hypothesis I proposed on the etiology of inflammatory bowel disease. This hypothesis suggested that both UC and CD are caused by weakening of the gut barrier due to damage of the protective mucus layer and the underlying tissue by the poorly inactivated digestive proteases resulting from a reduction of gut bacteria by dietary chemicals like saccharin and sucralose. However, the large amounts of bacteria in the colon make the recruitment of neutrophils and formation of crypt abscess the main manifestation of UC, while the infiltration of antigens and dietary particles in the small and large intestine mainly cause the recruitment of macrophages and formation of granulomas as the main manifestations in CD. The fast reacting and short life span of neutrophils make the fight and damage limited to the surface of the mucosa. In contrast, the long life span and constant movement of macrophages may bring the harmful agents deep into the tissue. Therefore, the pathogenesis of UC may be more like bacterial pneumonia, while CD may be more like pneumoconiosis or tuberculosis of the lung.

Entities:  

Keywords:  Crohn’s disease; Inflammatory bowel disease; Macrophages; Neutrophils; Pathogenesis; Ulcerative colitis

Year:  2013        PMID: 23946890      PMCID: PMC3740262          DOI: 10.4291/wjgp.v4.i3.63

Source DB:  PubMed          Journal:  World J Gastrointest Pathophysiol        ISSN: 2150-5330


  7 in total

Review 1.  Unravelling the pathogenesis of inflammatory bowel disease.

Authors:  R J Xavier; D K Podolsky
Journal:  Nature       Date:  2007-07-26       Impact factor: 49.962

Review 2.  The 10 remaining mysteries of inflammatory bowel disease.

Authors:  Jean-Frédéric Colombel; Alastair J M Watson; Markus F Neurath
Journal:  Gut       Date:  2007-12-13       Impact factor: 23.059

Review 3.  Pneumoconiosis: comparison of imaging and pathologic findings.

Authors:  Semin Chong; Kyung Soo Lee; Myung Jin Chung; Joungho Han; O Jung Kwon; Tae Sung Kim
Journal:  Radiographics       Date:  2006 Jan-Feb       Impact factor: 5.333

Review 4.  Etiology of inflammatory bowel disease: a unified hypothesis.

Authors:  Xiaofa Qin
Journal:  World J Gastroenterol       Date:  2012-04-21       Impact factor: 5.742

5.  The monocyte-macrophage system in granulomatous inflammation.

Authors:  J L Turk; R B Narayanan
Journal:  Haematol Blood Transfus       Date:  1981

Review 6.  Lung inflammatory response in pneumonia.

Authors:  C Montón; A Torres
Journal:  Monaldi Arch Chest Dis       Date:  1998-02

Review 7.  Mechanisms of granulomatous inflammation.

Authors:  W L Epstein; K Fukuyama
Journal:  Immunol Ser       Date:  1989
  7 in total
  2 in total

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Authors:  William J Sandborn; Maria T Abreu; Marla C Dubinsky
Journal:  Gastroenterol Hepatol (N Y)       Date:  2018-05

Review 2.  The Interrelationships between Intestinal Permeability and Phlegm Syndrome and Therapeutic Potential of Some Medicinal Herbs.

Authors:  Junghyun Park; Tae Joon Choi; Ki Sung Kang; Seo-Hyung Choi
Journal:  Biomolecules       Date:  2021-02-15
  2 in total

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