The role of the environment in the development of pediatric inflammatory bowel disease

A Aujnarain, DR Mack, EI Benchimol - Current gastroenterology reports, 2013 - Springer
A Aujnarain, DR Mack, EI Benchimol
Current gastroenterology reports, 2013Springer
The incidence of inflammatory bowel disease (IBD) is rising worldwide, with a particularly
sharp increase in children. Rates are highest in North America and Europe, with rapid
increases noted in developing nations adopting the Westernized environment. While many
genetic risk loci have been identified that predispose people to IBD, incomplete penetrance
and overlapping genotypes among patients with different phenotypes inadequately explain
the etiology of these chronic diseases. Therefore, environmental risk factors have been the …
Abstract
The incidence of inflammatory bowel disease (IBD) is rising worldwide, with a particularly sharp increase in children. Rates are highest in North America and Europe, with rapid increases noted in developing nations adopting the Westernized environment. While many genetic risk loci have been identified that predispose people to IBD, incomplete penetrance and overlapping genotypes among patients with different phenotypes inadequately explain the etiology of these chronic diseases. Therefore, environmental risk factors have been the subject of much recent research. This article reviews the role of the environment in IBD, with particular focus on early-life exposures and pediatric-onset disease. The literature surrounding environmental risk factors is reviewed, including prenatal and perinatal exposures, the hygiene hypothesis, the urban environment, infection and antibiotic use, and secondhand tobacco smoke exposure. In addition, the possible role of the environment in altering the intestinal microbiome is addressed.
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