Immunoregulation in the gut: success and failures in human disease

• Published in: Gut 2002-05, Vol.50 (suppl 3), p.iii60-iii64
• Main Authors: Monteleone, I, Vavassori, P, Biancone, L, Monteleone, G, Pallone, F
• Format: Article
• Language: English
• Subjects: antigen presenting cell; Antigens; APC; Apoptosis; Biological and medical sciences; CD4-Positive T-Lymphocytes - immunology; Colitis, Ulcerative - immunology; Crohn Disease - immunology; Crohn's disease; Cytokines; Cytokines - immunology; Digestive system; Growth factors; Growth Substances - metabolism; HIV; Human immunodeficiency virus; Humans; IBD; IFN; immunoglobulin; immunoregulation; Inflammation; Inflammatory bowel disease; Inflammatory Bowel Diseases - immunology; interferon; interleukin; Intestinal Mucosa - immunology; Investigative techniques, diagnostic techniques (general aspects); keratinocyte growth factor; KGF; lamina propria lymphocyte; lamina propria mononuclear cell; lamina propria T lymphocyte; LPL; LPMC; Lymphocyte Activation; Lymphocytes; Medical sciences; metalloproteinase; MMP; nuclear factor; Pathogenesis; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Peyer's patches; pokeweed mitogen; Proteins; PWM; Rodents; SEB; Signal transduction; Small intestine; staphylococcal enterotoxin B; Stromal Cells - metabolism; Studies; T-LPL; TGF; TIMP; tissue inhibitor of metalloproteinase; TNBS; trinitrobenzene sulphonic acid; tumour growth factor; ulcerative colitis; Ulcers
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.50.suppl_3.iii60

In normal conditions, human gut mucosa is infiltrated with a large number of mononuclear cells. This is a reflection of the fact that human intestine is continuously subjected to a massive stimulation by luminal antigens. This state of “physiological” inflammation is a tightly controlled phenomenon, as several mucosal cells interact to generate and maintain an appropriate local immune response. Changes in cell type number and/or function, including the release of soluble mediators, have been associated with the development of chronic inflammatory diseases, such as Crohn's disease (CD) and ulcerative colitis (UC), the two major forms of inflammatory bowel disease. Evidence also indicates that the type of inflammatory response occurring in the intestine of patients with CD differs from that in UC, and this probably reflects distinct pathways of immune activation. In CD mucosa, a Th1 response with high IL-12 and IFNγ production prevails, while in UC a humoral immunity appears to be predominant. Despite this, CD and UC share downstream inflammatory events, characterised by high levels of inflammatory cytokines, free radicals, matrix-degrading enzymes and growth factors.