Immunologic Mechanisms in Intestinal Diseases
- STEPHAN R. TARGAN, M.D.;
- MARTIN F. KAGNOFF, M.D.;
- MICHAEL D. BROGAN, M.D.; and
- FERGUS SHANAHAN, M.D.
Abstract
The intestine is a unique immunologic organ that comprises an afferent and efferent compartment and provides the host with the ability to respond through several different effector mechanisms against environmental factors. We discuss mechanisms in three intestinal diseases in this overview of the mucosal immune system. Genetic and immunologic factors are important in the pathogenesis of celiac disease, which is characterized by damage to the mucosa of the small intestine with resultant malabsorption. Pathogenic microbes are important environmental agents that interact with the intestinal mucosa and initiate local immune responses. Advances in the understanding of the mucosal immune response to these pathogenic microbes have produced a clear picture of the way in which this specialized immune system works in concert with systemic immunity. As to the autoimmune nature of inflammatory bowel disease, no specific antigen has been shown to incite the inflammatory reactions and neither the target cells nor the effector mechanism involved have been identified. Several factors exist, however, to suggest an autoimmune mechanism and the role of mucosal immunologic factors in this disease.
- autoimmune diseases
- B lymphocytes
- celiac disease
- Crohn disease
- colitis, ulcerative
- Giardia
- gliadins
- IgA, secretory
- immune mechanisms
- immune response
- inflammatory bowel disease
- intestinal mucosa
- intraepithelial lymphocytes
- killer cells, natural
- lamina propria
- macrophages
- malabsorption syndromes, major histocompatibility complex
- mast cells
- mucosal-associated lymphoid tissue
- Peyer patches
- T lymphocytes
- Trichinella
- Vibrio cholerae
Article and Author Information
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▸An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine, Los Angeles, California. William M. Pardridge, M.D., Professor of Medicine, is Director of Conferences.
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▸Authors who wish to cite a section of the conference and specifically indicate its author can use this example for the form of reference:
KAGNOFF MF. Pathogenesis of celiac disease, pp 857-9. In: TARGAN SR, moderator. Immunologic mechanisms in intestinal diseases. Ann Intern Med. 1987;106:853-870.
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Grant support: by a grant from the Harbor/UCLA Center for the Study of Inflammatory Bowel Disease, Public Health Service grants P30 AM32600 and AM35108 (Dr. Kagnoff) from the National Institutes of Health. Dr. Shanahan is a recipient of a research career development award from the National Foundation for Ileitis and Colitis.
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▸Requests for reprints should be addressed to Stephan R. Targan, M.D.; UCLA Inflammatory Bowel Disease Center, Department of Medicine, Division of Gastroenterology, UCLA School of Medicine; Los Angeles, CA 90024.
- © 1987 American College of Physicians
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