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Publication
Doença de Crohn
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| PPG_29688 | 1.91 MB | Adobe PDF |
Advisor(s)
Abstract(s)
A doença de Crohn é uma doença inflamatória, que tem a capacidade de afetar todo o
sistema gastrointestinal. É uma patologia crónica e transmural, que afeta toda a
espessura da parede do órgão. A sua etiologia e os seus fatores predisponentes
permanecem desconhecidos. Disbiose, defeito no desempenho da barreira da mucosa
intestinal, infeção crónica patogénica persistente, excessiva resposta imune perante
bactérias entéricas comensais normais são algumas das hipóteses mais predominantes
sobre a etiologia de DC.
No século XXI ainda existem muitas incertezas sobre a etiologia de DC, os fatores
genéticos continuam a ser o factor com maior peso como causa desta patologia, em
combinação com as alterações ou diminuição da permeabilidade da parede do intestino,
de fatores ambientais e dos antigénios persistentes.
Candida tropicalis, Esherichia coli, Serratia marcescens e Mycobacterium avium
paratuberculosis, são alguns exemplos de microorganismos identificados em doentes
com DC, embora ainda não existam evidências suficientes para consolidar uma relação
com esta patologia. Alterações no funcionamento do Sistema Imunitário estão
implicadas no desenvolvimento da DC.
A nível terapêutico, vários fármacos são usados com finalidade de controlar a
inflamação, atenuar os sintomas e melhorar algumas deficiências a nível nutricional. O
tratamento convencional é o mais usado apesar de que em casos mais agudos já não é o
suficiente para que se consiga obter uma resposta positiva, criando uma necessidade de
arriscar em novos tratamentos com maior eficácia.
Podemos concluir que apesar de todas estas décadas de estudos científicos as incertezas
no que diz respeito à patogénese da doença de Crohn continuam. Ainda há muito por
descobrir sobre a sua etiologia e patogenia.
CD is an inflammatory disease that can affect the entire gastrointestinal system. It is chronic and transmural and affects all the organ layers. Its etiology and predisponent factors are still unknown. Dysbiosis, defects of the intestinal barrier, persistent pathogenic chronic infection, excessive immune response to normal enteric commensal bacteria are some of the hypothesis for CD etiology. In the XXI century, there are a lot of uncertainties about CD etiology. Genetic factors are a primary cause of this pathology, combined with the alteration or decrease on the permeability of the gut wall, environmental factors and persistent antigens. Candida tropicalis, Esherichia coli, Serratia marcescens e Mycobacterium avium paratuberculosis, are few examples of microorganisms associated to CD, however there is not enough evidence to consolidate a connection to this pathology. The immune system is another important intervener on this condition. This system controls the innate and adaptive response as a defense against harmful agents and microorganisms. On a therapeutic level, several drugs are used to control inflammation and symptoms and improve nutritional deficits. Conventional treatment is the most used although in more acute cases it is not enough in order to get a positive response leading to the need of more effective treatments. In conclusion, despite all these decades of scientific studies, the uncertainties about CD pathogenesis continue and there is still a lot to be uncovered about its etiology and pathogenesis.
CD is an inflammatory disease that can affect the entire gastrointestinal system. It is chronic and transmural and affects all the organ layers. Its etiology and predisponent factors are still unknown. Dysbiosis, defects of the intestinal barrier, persistent pathogenic chronic infection, excessive immune response to normal enteric commensal bacteria are some of the hypothesis for CD etiology. In the XXI century, there are a lot of uncertainties about CD etiology. Genetic factors are a primary cause of this pathology, combined with the alteration or decrease on the permeability of the gut wall, environmental factors and persistent antigens. Candida tropicalis, Esherichia coli, Serratia marcescens e Mycobacterium avium paratuberculosis, are few examples of microorganisms associated to CD, however there is not enough evidence to consolidate a connection to this pathology. The immune system is another important intervener on this condition. This system controls the innate and adaptive response as a defense against harmful agents and microorganisms. On a therapeutic level, several drugs are used to control inflammation and symptoms and improve nutritional deficits. Conventional treatment is the most used although in more acute cases it is not enough in order to get a positive response leading to the need of more effective treatments. In conclusion, despite all these decades of scientific studies, the uncertainties about CD pathogenesis continue and there is still a lot to be uncovered about its etiology and pathogenesis.
Description
Keywords
Doença de Crohn Doença inflamatória intestinal Colite ulcerosa Terapêutica biológica Infliximab Azatioprina Sistema imunitário Crohn disease Inflammatory bowel disease Ulcerative colitis Biological therapy Infliximab Azathioprine Immunity system