GASTROENTEROLOGY ARTICLE OF THE WEEK
October 12, 2006
Sartor RB. Mechanisms of Disease: Pathogenesis of Crohn’s disease and ulcerative colitis. Nature Gastroenterol Hepatol 2006;3:390--407,
1. CARD15 mutations
a. used to be known as NOC2 mutations
b. are associated with distal ileal disease
c. is more common among African Americans
d. strictuing disease may be more prevalent in patients with this mutation
2. Antibiotics and IBD
a. antibiotics are usually ineffective in UC
b. antibiotics are more effective in Crohn’s colitis than in Crohn’s ileitis
c. Probiotics are useful in the treatment of active IBD
d. probiotics may help prevent relapses of pouchitis
3. Environmental triggers of IBD include
a. smoking which triggers Crohn’s and UC
b. stress
c. NSAID’s
d. Caffeine
e. Infections
4. Potential mechanisms that may explain chronicity in IBD include
a. Persistent mycobacterial infection
b. Dysbiosis
c. Enteroadherent E. coli infection
d. Ischemia
e. Early infestation with intestinal parasites
f. Defective microbial clearance
True or False
5. The MDR1 gene has been associated with ulcerative colitis
6. There is no convincing evidence that commensal bacteria are involved in the pathogenesis of IBD
7. Loss of tolerance to enteric commensal bacteria is seen in Crohn’s disease but not in UC
8. NFκB is activated in tissues of IBD patients and its inhibition can improve the colitis.
9. T cell response in Crohn’s disease is more TH1 – type, in contrast T cell response in U.C. tends to resemble more the TH2 profile.