Pathogenesis of IBD

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Pathogenesis of IBD

• Lloyd Mayer M.D.
• Mount Sinai Medical Center
• New York, NY, U.S.A.

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Model of IBD pathogenesis

• Antigen
• Appropriate
• Inappropriate

Mucosal Inflammation
Environment

• Modifiers
• Smoking
• Appendectomy

Genetics
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NOD2 mutations predispose to the development of
Crohns disease
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Immunologic Hypothesis of IBD

• Inflammatory bowel disease is due to a
  dysregulated mucosal immune (CD4 T cell)
  response to enteric bacterial antigens, in a
  genetically susceptible host.

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Summary and conclusions

• IBD reflects a combination of environmental,
  genetic and immunologic defects
• The common denominator is an aberrant immune
  response, either innate or adaptive
• Novel cytokines/receptors (e.g. IL23, IL17) play
  a unique role in disease pathogenesis and may be
  both distinct and overlapping in CD and UC
  resulting in the clinical expression of disease