Defective microbial sensing and clearance in perianal Crohns disease: a role for complement factor B

Fistulising perianal disease is one of the common presentations in Crohn’s disease (CD).1 Between 12% and 41% of patients with CD develop perianal complications of fistulising disease or abscesses.2 Whereas disease susceptibility in complex and multifactorial CD has been associated with over hundred genetic loci allowing insight into the pathophysiology, the genetic basis and functional mechanisms of disease subphenotypes such as fistulising perianal disease are less well understood and better mechanistic and therapeutic insights are needed.3 Under homeostatic conditions, tissue resident intestinal macrophages with high phagocytic activity ingest and eliminate translocating bacteria in the intestine without eliciting an inflammatory immune response.4 In inflammatory bowel disease (IBD), multiple factors including intestinal dysbiosis and possibly damaged epithelial barrier due to ulceration and inflammatory conditions can cause a significantly higher influx of translocating and potentially invading bacteria. To prevent systemic spreading of bacteria and...
Source: Gut - Category: Gastroenterology Authors: Tags: Gut Commentary Source Type: research