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Extraintestinal manifestations in inflammatory bowel disease - epidemiology, genetics, and pathogenesis.
- Source :
-
Expert review of gastroenterology & hepatology [Expert Rev Gastroenterol Hepatol] 2019 Apr; Vol. 13 (4), pp. 307-317. Date of Electronic Publication: 2019 Feb 20. - Publication Year :
- 2019
-
Abstract
- Introduction: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, primarily of, but not restricted to the gut. Extraintestinal manifestations (EIMs) are frequently observed and involve the joints, eyes, hepatobiliary tract, and skin. Areas covered: In this review, we discuss classical EIM focusing on epidemiology, genetics, and pathogenesis, highlighting recent advances in the understanding of EIM. We further discuss treatment-induced immunological phenomena, which are increasingly recognized and might challenge IBD-treating physicians in the era of biological treatment. Expert opinion: EIM considerably contributes to morbidity and mortality. Genetic studies have revealed a common genetic background between EIM and IBD and among specific EIM. Identified protein interactions have been shown to cluster in shared biological pathways. However - despite these recent advances - pathogenesis of EIM is at best partially understood. Several pathogenic mechanisms have been proposed such as upregulation of tumor necrosis factor, aberrant lymphocyte homing, and cross-reactive antigen presentation. It still remains unclear whether EIM is a direct result of the inflammatory process in the gut or rather a consequence of a shared genetic background leading to dysfunctional immune responses to environmental stimuli. Exploration and understanding of EIM genetics and pathophysiology will pave the road for better and more efficacious treatment options in the future.
- Subjects :
- Genetic Predisposition to Disease
Humans
Immunosuppressive Agents adverse effects
Phenotype
Prognosis
Risk Assessment
Risk Factors
Digestive System Diseases epidemiology
Digestive System Diseases genetics
Digestive System Diseases immunology
Digestive System Diseases therapy
Eye Diseases epidemiology
Eye Diseases genetics
Eye Diseases immunology
Eye Diseases therapy
Inflammatory Bowel Diseases drug therapy
Inflammatory Bowel Diseases epidemiology
Inflammatory Bowel Diseases genetics
Inflammatory Bowel Diseases immunology
Joint Diseases epidemiology
Joint Diseases genetics
Joint Diseases immunology
Joint Diseases therapy
Skin Diseases epidemiology
Skin Diseases genetics
Skin Diseases immunology
Skin Diseases therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1747-4132
- Volume :
- 13
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Expert review of gastroenterology & hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 30791773
- Full Text :
- https://doi.org/10.1080/17474124.2019.1574569