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Charles O. Elson, R. Balfour Sartor, Stephan R. Targan, William J. Sandborn, Challenges in IBD Research: Updating the Scientific Agendas, Inflammatory Bowel Diseases, Volume 9, Issue 3, 1 May 2003, Pages 137–153, https://doi.org/10.1097/00054725-200305000-00001
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Executive Summary
Crohn's & Colitis Foundation of America Research Priorities: Joint Agenda for Clinical and Basic Science
Substantial progress has been made since the first “Challenges in IBD Research” white paper was drafted in 1990. Advances in basic science—particularly in immunology, genetics, epithelial cell biology, signal transduction, molecular biology, and other areas—have added greatly to our understanding of disease pathogenesis and have identified many new targets for therapeutic intervention. One important realization that has emerged in the past few years is that a complex and active communication among the bacterial flora, epithelium, and immune cells exists in the intestine and that perturbation of these interactions can result in chronic intestinal inflammation. Thus, the major working hypothesis, particularly coming from basic research in experimental models, is that inflammatory bowel disease (IBD) is due to an abnormal cell-mediated immune reaction—primarily by CD4+ T cells—to the antigens and adjuvants of the enteric bacteria in genetically susceptible hosts. Consequently, many of the priorities and associated resources are directed at gaining a better understanding of the interactions between enteric bacteria and the host as well as the regulation of T-lymphocyte activation and differentiation.
