The growth in the number of chronic non-communicable diseases in the second half of the past century and in the first two decades of the new century is largely due to the disruption of the relationship between the human body and its symbiotic microbiota, and not pathogens. The interaction of the human immune system with symbionts is not accompanied by inflammation, but is a physiological norm. This is achieved via microbiota control by the immune system through a complex balance of pro-inflammatory and suppressive responses, and only a disturbance of this balance can trigger pathophysiological mechanisms. This review discusses the establishment of homeostatic relationships during immune system development and intestinal bacterial colonization through the interaction of milk glycans, mucins, and secretory immunoglobulins. In particular, the role of fucose and fucosylated glycans in the mechanism of interactions between host epithelial and immune cells is discussed.
Inflammatory bowel diseases (IBD) are immune-mediated diseases and usually manifest at a young age. They are requires in a long-term treatment or surgery with a high probability of surgical intervention. IBDs are accompanied by a decrease in working capacity, impaired quality of life and social disadaptation. However, timely diagnosis with using modern diagnostic methods, the use of evidence-based immunosuppressive and biological therapy significantly changed the pathomorphosis of this disease. But despite the achievements of the pharmacotherapy, the incidence and prevalence of IBD are still increasing, a demand for surgery remains both for Crohn`s disease and ulcerative colitis throughout all the period of illness. At the same time there is a trend towards the variability of symptoms, mismatch of the clinical symptoms with the real severity of inflammation, increase of a number of patients with extraintestinal manifestations and resistance to induction and maintenance therapies. In addition to this, the observation of this group of patients is complicated due to the difficulty of the early diagnosis and differential analysis of IBD, the need of early induction treatment according to the guidelines and the lack of adherence to the therapy.
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