What is irritable bowel disease characterized by?
Chronic recurrent inflammation of the GIT with no cure
List the two types of irritable bowel disease.
Crohn’s disease, Ulcerative colitis
Each type has distinct characteristics and causes.
What causes Crohn’s disease?
Smoking
In Crohn’s disease, inflammation can occur in a _______ pattern.
discontinuous
What are the common causes of Crohn’s disease? (cytokines)
- TNF
- IFN-γ
- IL-6
These are cytokines involved in the inflammatory response.
What prevents ulcerative colitis?
Smoking
It is characterized by inflammation only in the colon.
In ulcerative colitis, inflammation is _______.
continuous
It starts in the rectum and progresses upwards.
Why do UC patients need to be admitted to surveillence after 8-10 years
they have an increased risk of colon cancer due to prolonged inflammation.
List the common interleukins involved in IBD.
- IL-17A
- IL-17FF
- IL-21
- IL-22
These interleukins play roles in the inflammatory process.
What are the resolution interleukins in IBD?
- IL-10
- TGFB
These interleukins help resolve inflammation.
How is the severity of IBD detected?
- Number of bloody stools per day
- ESR
- Temperature
- Pulse
- Haemoglobin
These indicators help assess the level of inflammation.
What are the dermatological manifestations of IBD?
- Erythema nodosum
- Pyoderma gangrenosum
Skin lesions can occur in both types of IBD.
What are the rheumatologic manifestations of IBD?
- Arthritis
- Lower bone density
- Ankylosing spondylitis
These conditions can arise due to prolonged steroids and inflammation.
What are the ocular manifestations of IBD?
- Conjunctivitis
- Iritis
- Episcleritis
Symptoms include ocular pain and blurred vision.
What are the vascular manifestations of IBD?
Thrombosis
This can occur as a complication of the disease.
What is the autoimmune condition associated with IBD?
T cell response and dysfunctions in innovative and adaptive immunity
This leads to inflammation.
What type of response is associated with Crohn’s disease?
TH1 response
This is part of the immune response involved.
What type of response is associated with ulcerative colitis?
TH2 response
This reflects the different immune mechanisms at play.
What is a significant environmental risk factor for IBD?
Smoking
Other factors include pollution, exercise, diet, and stress.
What are the treatments for IBD?
- Corticosteroids
- Aminosalicylates
- Immunosuppressants
- Biologic agents
What is the mode of action of corticosteroids?
Anti-inflammatory effect by decreasing transcription of IL-1, IL-6, IL-12, and TNFα
They are used in mild/moderate IBD.
What is an example of an aminosalicylate?
Sulfasalazine
It breaks down in the gut into the active form 5-ASA.
What is the mode of action of methotrexate?
Inhibits Dihydrofolate reductase + tetrahydrofolate
This leads to decreased T-cell proliferation and intestinal inflammation.
What do biologic agents target in IBD treatment?
Tumour necrosis factor alpha (TNF-α)
They prevent TNF-α binding to receptors, reducing inflammation.
