<Review>Immunological aspects of inflammatory bowel disease

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The etiologic agents for ulcerative colitis and Crohn's disease have not been identified. Although a large number of microbial and dietary agents have been proposed as candidates for roles in these diseases, none have been proven as causative agents. The mechanisms for the spontaneous exacerbations and remissions, characteristics of these diseases, are also undefined. Nevertheless, recent studies have provided new insight into the mechanisms involved in the initiation, production, and amplification of the immunologic and inflammatory responses that lead to the histologic findings and pathologic changes characteristic of inflammatory bowel disease (IBD). Inflammatory mediators and cytokines have been viewed as particularly promising for understanding both chronic inflammation of the intestine as well as providing important pathophysiologic mechanisms to target for therapeutic intervention. Although the cellular and molecular mechanisms inducing intestinal inflammation may not be unique to IBD, recent insight into the role of the mucosal immune system in the pathophysiology of IBD are beginning to lead to promising new therapeutic approaches. Of great future interest will be the delineation of the mechanisms involved in the downregulation of inflammation, a process that normally leads to the prompt resolution of specific, acute intestinal inflammation. Although little is known about the normal physiologic downregulation of inflammatory responses, this area is of great potential importance for future therapeutic approaches in IBD.
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<Review>Immunological aspects of inflammatory bowel disease

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