TY - JOUR
T1 - Differences in epidemiological features between ulcerative colitis and Crohn's disease
T2 - The early life-programmed versus late dysbiosis hypothesis
AU - Beaugerie, Laurent
AU - Langholz, Ebbe
AU - Nyboe-Andersen, Nynne
AU - Pigneur, Bénédicte
AU - Sokol, Harry
AU - ECCO Epicom
PY - 2018/6
Y1 - 2018/6
N2 - It is increasingly admitted that Crohn's disease and ulcerative colitis, the two entities of inflammatory bowel disease, are initiated and reactivated by environmental factors in genetically susceptible hosts, and result from aberrant immune response to specific intestinal microbes, in the context of altered composition of intestinal microbiota, called dysbiosis. We hypothesize that the role of the gut microbiota in Crohn's disease pathogenesis is linked to early-life abnormal crosstalk with the host immune system under construction. By contrast, in ulcerative colitis, the detrimental effect of intestinal dysbiosis could occur at any time of life, due to instant environment. This hypothesis could explain why the incidence of Crohn's disease raises many years later than that of ulcerative colitis in developing countries that adopt the Western lifestyle. This would also explain why many early-life events, such as caesarean section, increased hygiene and repeated antibiotic exposure, are risk factors for subsequent development of Crohn's disease, but not ulcerative colitis.
AB - It is increasingly admitted that Crohn's disease and ulcerative colitis, the two entities of inflammatory bowel disease, are initiated and reactivated by environmental factors in genetically susceptible hosts, and result from aberrant immune response to specific intestinal microbes, in the context of altered composition of intestinal microbiota, called dysbiosis. We hypothesize that the role of the gut microbiota in Crohn's disease pathogenesis is linked to early-life abnormal crosstalk with the host immune system under construction. By contrast, in ulcerative colitis, the detrimental effect of intestinal dysbiosis could occur at any time of life, due to instant environment. This hypothesis could explain why the incidence of Crohn's disease raises many years later than that of ulcerative colitis in developing countries that adopt the Western lifestyle. This would also explain why many early-life events, such as caesarean section, increased hygiene and repeated antibiotic exposure, are risk factors for subsequent development of Crohn's disease, but not ulcerative colitis.
KW - Colitis, Ulcerative/epidemiology
KW - Crohn Disease/epidemiology
KW - Dysbiosis/complications
KW - Emigration and Immigration
KW - Gastrointestinal Microbiome/immunology
KW - Humans
KW - Models, Biological
KW - Risk Factors
U2 - 10.1016/j.mehy.2018.03.009
DO - 10.1016/j.mehy.2018.03.009
M3 - Journal article
C2 - 29685190
SN - 0306-9877
VL - 115
SP - 19
EP - 21
JO - Medical Hypotheses
JF - Medical Hypotheses
ER -