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Infectious etiopathogenesis of Crohn's disease

World Journal of Gastroenterology 2014年第34期20卷 12102-12117页

作者： Jessica Carriere Arlette Darfeuille-Michaud Hang Thi Thu Nguyen Clermont Universite M2iSHUMR 1071 Inserm University of Auvergne 63001 Clermont-FerrandFrance INRA USC 2018 63000 Clermont-FerrandFrance Centre Hospitalier Universitaire 63000 Clermont-FerrandFrance

Important advances during the last decade have been made in understanding the complex etiopathogenesis of Crohn’s disease(CD).While many gaps in our knowledge still exist,it has been suggested that the etiology of CD is multifactorial including genetic,environmental and infectious factors.The most widely accepted theory states that CD is caused by an aggressive immune response to infectious agents in genetically predisposed individuals.The rise of genome-wide association studies allowed the identification of loci and genetic variants in several components of host innate and adaptive immune responses to microorganisms in the gut,highlighting an implication of intestinal microbiota in CD etiology.Moreover,numerous independent studies reported a dysbiosis,i.e.,a modification of intestinal microbiota composition,with an imbalance between the abundance of beneficial and harmful bacteria.Although microorganisms including viruses,yeasts,fungi and bacteria have been postulated as potential CD pathogens,based on epidemiological,clinicopathological,genetic and experimental evidence,their precise role in this disease is not clearly defined.This review summarizes the current knowledge of the infectious agents associated with an increased risk of developing CD.Therapeutic approaches to modulate the intestinal dysbiosis and to target the putative CD-associated pathogens,as well as their potential mechanisms of action are also discussed.

关键词： Crohn's disease Intestinal microbiota Dysbiosis adherent-invasive escherichia coli Probiotics Antibiotics Fecal microbiota transplantation

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