The role of gastrointestinal pathogens in inflammatory bowel disease: a systematic review

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  • Jordan E. Axelrad
    Division of Gastroenterology, Department of Medicine, NYU Grossman School of Medicine, Inflammatory Bowel Disease Center, NYU Langone Health, 305 East 33rd Street, Lower Level, New York, NY 10016, USA
  • Ken H. Cadwell
    Division of Gastroenterology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
  • Jean-Frederic Colombel
    Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
  • Shailja C. Shah
    Section of Gastroenterology, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN

説明

<jats:p> The inflammatory bowel diseases (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), are chronic, progressive, inflammatory conditions of the gastrointestinal tract. Imbalance in the gut microbial community, or dysbiosis, and the subsequent immune response, represent the critical relationship between genetic susceptibility, microbes, and environment factors, that result in IBD. Gastrointestinal pathogens – a common cause of dysbiosis – have been implicated as an environmental trigger in new onset IBD, as well as flare of existing IBD. In this article, we systematically review clinical data regarding the association between specific gastrointestinal pathogens and IBD. Numerous bacteria, viruses, fungi, and parasites have been implicated in the pathogenesis of IBD, and exacerbations of existing disease. In this article, we will also specifically discuss the less recognized microbes that have an inverse association with IBD, including certain bacterial pathogens, such as Helicobacter pylori, and parasites, such as Trichuris species. Future prospective and experimental studies are required to establish causality and clarify potential mechanisms of enteric pathogens in modifying the risk and course of IBD. </jats:p>

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