Role of Infections in the Manifestation or Reactivation of Inflammatory Bowel Diseases

Stallmach, Andreas; Carstens, Ove

doi:10.1097/00054725-200205000-00009

Cited by 70 publications

(34 citation statements)

References 23 publications

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“…In other words, it should be verified whether specific Ags or PAMPs from the commensal bacteria are essential for the priming or memory phase. Consistently, the current study also provides an explanation of why a common recurrence of IBD is observed during complication of microbial infection, such as acute Salmonella enterocolitis, which may possibly supply large amounts of "bystander" PAMPs (31).…”

Section: Discussionsupporting

confidence: 81%

MyD88-Dependent Pathway in T Cells Directly Modulates the Expansion of Colitogenic CD4+ T Cells in Chronic Colitis

Tomita

Kanai

Fujii

et al. 2008

The Journal of Immunology

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TLRs that mediate the recognition of pathogen-associated molecular patterns are widely expressed on/in cells of the innate immune system. However, recent findings demonstrate that certain TLRs are also expressed in conventional TCRαβ+ T cells that are critically involved in the acquired immune system, suggesting that TLR ligands can directly modulate T cell function in addition to various innate immune cells. In this study, we report that in a murine model of chronic colitis induced in RAG-2−/− mice by adoptive transfer of CD4+CD45RBhigh T cells, both CD4+CD45RBhigh donor cells and the expanding colitogenic lamina propria CD4+CD44high memory cells expresses a wide variety of TLRs along with MyD88, a key adaptor molecule required for signal transduction through TLRs. Although RAG-2−/− mice transferred with MyD88−/−CD4+CD45RBhigh cells developed colitis, the severity was reduced with the delayed kinetics of clinical course, and the expansion of colitogenic CD4+ T cells was significantly impaired as compared with control mice transferred with MyD88+/+CD4+CD45RBhigh cells. When RAG-2−/− mice were transferred with the same number of MyD88+/+ (Ly5.1+) and MyD88−/− (Ly5.2+) CD4+CD45RBhigh cells, MyD88−/−CD4+ T cells showed significantly lower proliferative responses assessed by in vivo CFSE division assay, and also lower expression of antiapoptotic Bcl-2/Bcl-xL molecules and less production of IFN-γ and IL-17, compared with the paired MyD88+/+CD4+ T cells. Collectively, the MyD88-dependent pathway that controls TLR signaling in T cells may directly promote the proliferation and survival of colitogenic CD4+ T cells to sustain chronic colitis.

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Section: Discussionsupporting

confidence: 81%

MyD88-Dependent Pathway in T Cells Directly Modulates the Expansion of Colitogenic CD4+ T Cells in Chronic Colitis

Tomita

Kanai

Fujii

et al. 2008

The Journal of Immunology

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“…As intestinal infections by enteropathogens are associated with both IBD onset and IBD relapses, stool microbiologic studies are usually advised in patients with IBD relapses [11]. However, the incidence and clinical relevance of such infections have not been appropriately assessed, and only 2 prospective studies including a small number of patients have been published to date.…”

Section: Discussionmentioning

confidence: 99%

Prospective, Observational, Cross-Sectional Study of Intestinal Infections among Acutely Active Inflammatory Bowel Disease Patients

Navarro-Llavat¹,

Domènech

Bernal³

et al. 2009

Digestion

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Background: Intestinal infections have been claimed to precipitate or aggravate flares of inflammatory bowel disease (IBD). The reported incidence of such infections among IBD patients varies between 9 and 13%, but only a few prospective studies have been conducted. Aims: To evaluate the incidence of intestinal infections by enteropathogens in patients with active IBD, their impact on clinical outcome, and to identify associated risk factors. Patients and Methods: Consecutive patients admitted because of a relapse or suspected onset of IBD were prospectively included. At admittance, stool samples for culture, examination for intestinal parasites, and cytotoxin assay for Clostridium difficile were collected. Baseline clinical characteristics, potential risk factors for gastrointestinal infections, and clinical outcome were recorded. Results: Ninety-nine episodes were included. Six intestinal infections were diagnosed in 6 patients (5 ulcerative colitis, 1 ileocolonic Crohn’s disease), Campylobacter jejuni being the most frequent isolated microbe (n = 5). None of the patients with intestinal infection needed surgery, but two of them required second-line therapies. Conclusions: Gastrointestinal infections among IBD patients do not exceed 10% and occur mostly in patients with extensive involvement of the colon. Infection by enteropathogenic bacteria does not appear to be associated with a poorer clinical outcome of the IBD flare.

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“…The tolerance which exists under a normal healthy state towards resident intestinal flora is broken in active IBD [19], which implies the triggering role of bacterial infection in the flare of IBD. As many human infectious pathogens appear in a regular seasonal pattern [20,21], seasonal exposure to infectious agents may induce bursts of immune diseases, such as IBD [22,23], and there may be an association between the month of birth and risk of developing IBD later in life [24]. In the Asian area, bacterial infections show a seasonal pattern of occurrence that peaks in the spring and summer [25,26], but viral infections generally occur in the autumn and spring [27], which is slightly different from the seasonality found in Western populations according to a number of epidemiological studies [28,29].…”

Section: Discussionmentioning

confidence: 99%

Seasonality in Flares and Months of Births of Patients with Ulcerative Colitis in a Chinese Population

Bai

Guo

Shen³

et al. 2008

Dig Dis Sci

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Background and Aims Reports on seasonality in flares or months of births of inflammatory bowel disease patients have been inconsistent, but little data are available in a Chinese population. The aim of this study was to determine whether symptom flares and births of ulcerative colitis (UC) patients follow a seasonal pattern. Methods Patients with a diagnosis of UC established between January 1990 and December 2007 were investigated according to the occurrence of flares of symptoms and months of births. The expected flares or births were calculated on a monthly basis over the study period, taking into consideration the difference in the number of days in the month in each year. Results A total of 409 UC patients were included in the study, and 1030 flares of symptoms were determined. The peak number of flares occurred during the spring and summer, especially in June, while the nadir occurred in the winter, especially in January (v 2 (11 df) = 32.74304, P \ 0.005). The symptom flares also occurred more frequently in the spring-summer period than in the autumnwinter period (v 2 (3 df) = 22.1269, P \ 0.001). There was no statistical difference in birth distribution on a monthly or seasonal (spring, summer, autumn, winter) basis. However, the births of UC patients occurred more frequently in the autumn-winter period than in the spring-summer period when the data were merged into these two seasonal components (v 2 (1 df) = 5.255607, P \ 0.025). Conclusions The data indicate that the symptom flares of UC occurred more frequently in the spring and summer, while the births of UC patients occurred more often in the autumn and winter. Environmental recurring factors may be associated with the symptom flares of UC, and these factors during pregnancy or postpartum may be associated with susceptibility to UC later in life.

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Role of Infections in the Manifestation or Reactivation of Inflammatory Bowel Diseases

Cited by 70 publications

References 23 publications

MyD88-Dependent Pathway in T Cells Directly Modulates the Expansion of Colitogenic CD4+ T Cells in Chronic Colitis

MyD88-Dependent Pathway in T Cells Directly Modulates the Expansion of Colitogenic CD4+ T Cells in Chronic Colitis

Prospective, Observational, Cross-Sectional Study of Intestinal Infections among Acutely Active Inflammatory Bowel Disease Patients

Seasonality in Flares and Months of Births of Patients with Ulcerative Colitis in a Chinese Population

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