Author(s):
Dieren, J.M. van
Date (Issued):
2007-04-18
Keywords:
inflammatory disorders
Abstract:
Intestinal homeostasis is a sophisticated interplay between various endogenous-, genetic- and environmental factors. Therefore, combinations of defective endogenous gene expression and exogenous agents such as dietary antigens, cigarette smoke, drugs and micro fl ora can result in dysregulated mucosal immune responses. Inflammatory Bowel Disease (IBD) is a multifactorial chronic inflammatory condition of the intestine. As can be predicted from the multiple endogenous and exogenous factors that influence the disease, IBD may present with a very heterogeneous range of phenotypes. When IBD affects the colon in a superficial continuous ulcerative fashion, this disorder is referred to as ulcerative colitis (UC), whereas Crohns Disease (CD) is rather a transmural granulomatous disorder, which can affect any part of the gastrointestinal tract. However, many presentations of IBD cannot be conclusively identified as either UC or CD and are referred to as indeterminate colitis. Mucositis is an intestinal inflammatory condition most often induced by exogenously administered chemotherapy such as methotrexate (MTX). Chemotherapeutics inhibit the division of rapidly dividing cells such as tumor cells, but also of intestinal epithelial cells causing a disruption of the epithelial barrier. Endogenous factors such as associated with the genetic susceptibility for epithelial barrier disruption or the endogenous effect on the metabolism of the chemotherapy also influence the susceptibility for mucositis.