Pediatric Inflammatory Bowel Disease: from a translational perspective

Crohn’s disease (CD) and ulcerative colitis (UC), the two main subtypes of inflammatory bowel disease (IBD), are chronic relapsing inflammatory disorders of the gastrointestinal tract that have a peak age of onset in the second decade of life in children. There is strong evidence to support that dysregulation of the normally controlled immune response to commensal bacteria in a genetically susceptible individual drives IBD. Patients typically suffer from frequent and chronically relapsing flares, resulting in abdominal pain, diarrhea, rectal bleeding and weight loss. In CD, inflammation is transmural and often discontinuous. In UC, inflammatory changes typically involve the superficial mucosal and submucosal layers of the intestinal wall. CD most commonly involves the ileum and colon, but can affect any region of the gut. UC classically involves the rectum and inflammation may extend as far as the caecum in a typical continuous pattern. Patients with IBD may have various extra-intestinal symptoms such as oral ulcers, uveitis, arthalgias or arthritis and sclerosing cholangitis. IBD is heritable, 5 to 20% of the patients have a family history of the disease. This positive family history of IBD is more frequently observed in patients with CD than in UC. In IBD, there is a significantly higher rate of disease concordance in monozygotic twins compared with dizygotic twins.

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