Editorial
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 21, 2007; 13(15): 2145-2149
Published online Apr 21, 2007. doi: 10.3748/wjg.v13.i15.2145
Recent advances in basic and clinical aspects of inflammatory bowel disease: Which steps in the mucosal inflammation should we block for the treatment of inflammatory bowel disease?
Hitoshi Asakura, Kenji Suzuki, Terasu Honma
Hitoshi Asakura, Director of International Medical Information Center, Emeritus Professor at Niigata University, Japan
Kenji Suzuki, Department of Internal Medicine, Niigata University Medical and Dental Hospital, Japan
Terasu Honma, Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Hitoshi Asakura, MD, Shinanomachi Rengakan, 35 Shinanomachi, Shinjukuku, Tokyo, 160-0016, Japan. asakura_ht@imic.or.jp
Telephone: +81-3-53617080 Fax: +81-3-53617155
Received: March 7, 2007
Revised: March 10, 2006
Accepted: March 12, 2007
Published online: April 21, 2007
Abstract

There are four steps in the interaction between intestinal microbes and mucosal inflammation in genetically predisposed individuals from the viewpoints of basic and clinical aspects of inflammatory bowel disease (IBD). The first step is an interaction between intestinal microbes or their components and intestinal epithelial cells via receptors, the second step an interaction between macrophages and dendritic cells and mucosal lymphocytes, the third step an interaction between lymphocytes and vascular endothelial cells, and the fourth step an interaction between lymphocytes and granulocytes producing proinflammatory cytokines or free radicals and mucosal damage and repair. Recent therapeutic approaches for IBD aim to block these four steps in the intestinal inflammation of patients with IBD.

Keywords: Ulcerative colitis; Crohn’s disease; infla-mmatory bowel disease; Treatment; Immunology