[The Role of the Exposome in the Emergence of Chronic Inflammatory Bowel Diseases]

Abstract

The Role of the Exposome in the Emergence of Chronic Inflammatory Bowel Diseases Abstract. Inflammatory Bowel Disease (IBD) including Crohn's disease (CD) and ulcerative colitis (UC), are chronic inflammatory conditions of the gut related to a combination of genetic and environmental factors that impact on normal host-microbe interactions. The gastrointestinal tract is exposed to an overwhelming load of foreign antigens arising from commensal microorganisms, dietary products and occasional pathogens. But these factors explain only a small fraction of disease risk. During the last two decades advances in genomics, epigenomics and understanding of the intestinal microbiota have improved our knowledge in IBD pathogenesis. Although our ability to predict relapses and response to treatment remains limited, the importance of the external environment to modify the risk of IBD and to precipitate relapses in patients with established disease rises. The term 'exposome' is proposed to reflect a life-course of environmental influences beginning in-utero and proceeding right through childhood to adulthood. While the exposome is still a concept which needs practical perspective to enable better patient care, this review highlights important components of environmental contributors to improve our understanding on pathophysiologic mechanisms in IBD.