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• W2095495845 endingPage "562" @default.
• W2095495845 startingPage "533" @default.
• W2095495845 abstract "A complex interplay exists between the gastrointestinal system and other organ systems. The intestinal immune system plays an essential role in the human host resistance to bacteria, viruses, and parasites and in host response to environmental antigens. The human gastrointestinal tract contains up to 80% of all immunoglobulin-producing cells in the body.19 The specific cells that are important for immune function in the intestinal mucosa lie in close proximity to the luminal antigens and pathogenic microbes. The mechanical barrier formed by intestinal epithelial cells, intestinal motility, gastric acid, and proteolytic enzymes is important in protecting the host from potentially injurious materials in the intestine. These protective elements, however, may be less efficient in certain conditions and disease states, mandating that the human body employ a complex and multifaceted system of immune response. Another important factor in the predilection for disease and immune responsiveness is the major histocompatibility complex (MHC). Human leukocyte antigen (HLA) class I and class II genes are located in the MHC on chromosome 6. These genes code for glycoproteins, which bind peptides, and this HLA-peptide complex is recognized by certain T-cell receptors in the intestinal mucosa and elsewhere.14, 31 Susceptibility to at least 50 diseases, including ankylosing spondylitis (AS), reactive arthritis, Reiter's syndrome, and inflammatory bowel disease (IBD) accompanied by sacroiliitis, has been associated with specific HLA class I or class II alleles. All of the aforementioned disorders are associated with MHC class I HLA-B27.108, 161 The gastrointestinal tract has a significant role in the manifestations of diseases elsewhere in the body. One of the most significant extraintestinal manifestations of gastrointestinal disease is rheumatic disorders. Rheumatic disorders, such as scleroderma, may produce significant gastrointestinal effects, and nonsteroidal anti-inflammatory drugs (NSAIDs), essential in the treatment of various rheumatic disorders, can have significant morbidity and mortality associated with gastrointestinal tract damage. In addition, diseases of the gastrointestinal tract, liver, or pancreas may produce significant rheumatic manifestations. In some cases, specific therapies directed toward gastrointestinal disease may relieve or decrease the extraintestinal manifestations, as in treatment of the peripheral arthropathy of IBD. Alternatively the treatment of chronic gastrointestinal ailments may cause rheumatic diseases, as is the case with corticosteroids and osteoporosis. The gastrointestinal diseases with rheumatic manifestations can be broadly subdivided into two categories: intestinal disorders and disorders of the liver, biliary tree, and pancreas (Table 1). In the former, the functions of intestinal permeability and immune responsiveness are likely of fundamental importance.91, 120, 183 In the latter category, elements such as the production of autoantibodies and changes in the production or blood levels of numerous cytokines or pancreatic enzymes appear to play a critical role.10, 34, 50, 101, 128, 175 The features of each disorder and the putative or theoretic inciting factors are discussed separately." @default.
• W2095495845 created "2016-06-24" @default.
• W2095495845 creator A5039292176 @default.
• W2095495845 creator A5044524314 @default.
• W2095495845 date "1998-09-01" @default.
• W2095495845 modified "2023-09-24" @default.
• W2095495845 title "RHEUMATOLOGIC MANIFESTATIONS OF GASTROINTESTINAL DISEASES" @default.
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