IBD Case Study

Inflammatory Bowel Disease

Chronic inflammation of the gut, with structural integrity of mucosa compromised

Inflammatory Bowel Syndrome

No visible inflammation, GI mucosa looks normal but does not function optimally

Altered microbiome, NOD R

IBD

• __ __ - Inadequate regulated immune responses to commensal bacteria

• Can result from __ _ polymorphisms

Crohn’s Disease

Involves entire thickening of mucosal wall lining of gut, usually at terminal ileum

Ulcerative Colitis

Thickening of mucosal lining of colon only

IBD Sx

Abd pain, vomiting, diarrhea, weight loss

NOD R gene polymorphism

Involved in recognizing bacterial peptidoglycan (polymorphism for IBD)

ATG16L1 protein polymorphism

Involved in autophagy

(polymorphism for IBD)

IL23R polymorphism

Involved in Interleukin 23 R // cytokine signaling molecule

(polymorphism for IBD)

IRGM polymorphism

Involved in Interferon inducible protein (polymorphism for IBD)

Tight junctions, goblet, paneth, NOD, antigen, effector, regulatory

Chronic Inflammation in IBD

• Weakening of __ __ between epithelial cells

• Thinner mucus layer = dysfunctional __ cells and __ cells

• __ impairment and impaired __-presentation

• Disrupted balance between __ T cells and __ T cells

Corticosteroids, 6-mercaptopurine, methotrexate, Monoclonal antibodies, Acetaminophen

Pharm Tx for IBD - (5)

Surgery, liquid diet, parenteral nutrition

Other Tx for IBD

• __ for obstructions, fistulas, large abscesses

• Bowel rest - __ __ or __ __ temporarily

Adaptive, innate

• Celiac disease affects __ immunity

• IBD (Crohn’s and Ulcerative Colitis) affect __ immunity