Résumé
Les Maladies Inflammatoires Chroniques de l’Intestin (MICI) résultent d’une réponse immune non contrôlée face à des facteurs environnementaux non toxiques/pathogènes pour les individus sains. Depuis quelques années, grâce à l’essor de la génétique et des moyens techniques de la recherche fonctionnelle, les anomalies de l’immunité innée et adaptative, ont été identifiées dans les MICI. Ainsi dans la maladie de Crohn, avec atteinte iléale, l’initiation des lésions inflammatoires vient probablement d’un déficit immunitaire de la barrière intestinale. Ce déficit peut s’observer en cas d’altération des voies dépendantes du gène NOD2 et de l’autophagie. Il est fréquent d’observer une altération fonctionnelle des cellules de Paneth. Dans la rectocolite hémorragique (RCH), il est suspecté que les cellules épithéliales du côlon, particulièrement les cellules caliciformes, puissent avoir des rôles immunitaires, et générer des réponses inflammatoires à des facteurs environnementaux. Dans les 2 types de MICI, des anomalies de régulation du système immunitaire adaptatif sont observées, comme les sécrétions importantes de TNF et la présence de lymphocytes T agressifs, comme les Th17. Mais ces anomalies immunes, si elles sont essentielles à la physiopathologie des MICI, n’en sont pas l’unique élément. Il faut les analyser en intégration avec les facteurs d’environnement, les vaisseaux et l’épithélium digestif, ce qui reste difficile et nécessite des modèles et des moyens d’analyse bioinformatique complexes.
Abstract
Inflammatory bowel diseases (IBD) results from an uncontrolled immune response to non-toxic/pathogenic environmental factors for healthy individuals. In recent years, thanks to the development of genetics and technical functional research, abnormalities of the innate and adaptive immunity, have been identified in IBD. Also in Crohn’s disease (CD) with ileal involvment, the initiation of inflammatory lesions is probably due to an immune deficiency of the intestinal barrier. This deficit can be observed in case of alteration of the NOD2 gene dependent pathways and autophagy. Ileal CD is also commonly associated with a functional alteration of Paneth cells, and defensin deficiency. In ulcerative colitis (UC), it is suspected that the epithelial cells of the colon, particularly goblet cells, may have immune roles and could generate inflammatory responses to environmental factors. In the 2 types of IBD, abnormalities in the regulation of the adaptive immune system are observed, as significant secretion of TNF and the presence of aggressive T cells, as Th17. But these immune abnormalities, if they are essential to the pathogenesis of IBD, are not the only element. We must analyze their integration with environmental factors, blood vessels and gastrointestinal epithelium, which remains difficult and requires complex models and bioinformatics analysis means.
Références
Pelaseyed T, Bergstrom JH, Gustafsson JK, et al (2014) The mucus and mucins of the goblet cells and enterocytes provide the first defense line of the gastrointestinal tract and interact with the immune system. Immunol Rev 260:8–20
Adolph TE, Tomczak MF, Niederreiter L, et al (2013) Paneth cells as a site of origin for intestinal inflammation. Nature 503:272–6
Nalle SC, Turner JR. (2015) Intestinal barrier loss as a critical pathogenic link between inflammatory bowel disease and graftversus- host disease. Mucosal Immunol 8:720–30
Fritz T, Niederreiter L, Adolph T, et al (2011) Crohn’s disease: NOD2, autophagy and ER stress converge. Gut 60:1580–8
Deuring JJ, Fuhler GM, Konstantinov SR, et al (2014) Genomic ATG16L1 risk allele-restricted Paneth cell ER stress in quiescent Crohn’s disease. Gut 63:1081–91
Wang MH, Achkar JP (2015) Gene-environment interactions in inflammatory bowel disease pathogenesis. Curr Opin Gastroenterol 31:277–82
Strober W, Asano N, Fuss I, et al (2014) Cellular and molecular mechanisms underlying NOD2 riskassociated polymorphisms in Crohn’s disease. Immunol Rev 260:249–60
Parkes M. (2012) Evidence from genetics for a role of autophagy and innate immunity in IBD pathogenesis. Dig Dig 30:330–3
Nguyen HT, Lapaquette P, Bringer MA, et al (2013) Autophagy and Crohn’s disease. J Innate Immun 5:434–43
Sokol H, Conway KL, Zhang M, et al (2013) Card9 mediates intestinal epithelial cell restitution, Thelper 17 responses, and control of bacterial infection in mice. Gastroenterology 145:591–601 e3
Neurath MF. (2014) Cytokines in inflammatory bowel disease. Nat Rev Immunol 14:329–42
Galvez J. (2014) Role of Th17 Cells in the Pathogenesis of Human IBD. ISRN Inflamm 928461
Catana CS, Berindan Neagoe I, Cozma V, et al (2015) Contribution of the IL-17/IL-23 axis to the pathogenesis of inflammatory bowel disease. World J Gastroenterol 21:5823–30
Bekiaris V, Persson EK, Agace WW. (2014) Intestinal dendritic cells in the regulation of mucosal immunity. Immunol Rev 260:86–101
Eksteen B. (2015) Targeting of gut specific leucocyte recruitment in IBD by vedolizumab. Gut 64:8–10
Okamoto R, Watanabe M. (2015) Role of epithelial cells in the pathogenesis and treatment of inflammatory bowel disease. J Gastroenterol
Treton X, Pedruzzi E, Cazals-Hatem D, et al (2011) Altered endoplasmic reticulum stress affects translation in inactive colon tissue from patients with ulcerative colitis. Gastroenterology 141:1024–35
Treton X, Pedruzzi E, Guichard C, et al (2014) Combined NADPH oxidase 1 and interleukin 10 deficiency induces chronic endoplasmic reticulum stress and causes ulcerative colitis-like disease in mice. PLoS One 9:e101669
Kostic AD, Xavier RJ, Gevers D. (2014) The microbiome in inflammatory bowel disease: current status and the future ahead. Gastroenterology 146:1489–99
West CE, Renz H, Jenmalm MC, et al (2015) The gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies. J Allergy Clin Immunol 135:3–13; quiz 14.
Andersen V, Olsen A, Carbonnel F, et al (2012) Diet and risk of inflammatory bowel disease. Dig Liver Dis;44:185–94
Lee D, Albenberg L, Compher C, et al (2015) Diet in the pathogenesis and treatment of inflammatory bowel diseases. Gastroenterology 148:1087–106
Pineton de Chambrun G, Body-Malapel M, Frey-Wagner I, et al (2014) Aluminum enhances inflammation and decreases mucosal healing in experimental colitis in mice. Mucosal Immunol 7:589–601
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Treton, X. Immunité et Maladies Inflammatoires Chroniques de l’Intestin (MICI). Colon Rectum 9, 210–216 (2015). https://doi.org/10.1007/s11725-015-0607-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11725-015-0607-1