What sequence of pathogenetic events leads to acute... : Diseases of the Colon & Rectum (original) (raw)
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What sequence of pathogenetic events leads to acute ulcerative colitis?
Roediger, W. E.W. M.B., B.Ch., M.Sc., D.Phil. (Oxon), F.R.A.C.S.1
Editor(s): Smith, Lee E. M.D.
Editor
1Department of Surgery
The University of Adelaide at The Queen Elizabeth Hospital
Adelaide
Australia
2University Department of Surgery
The Queen Elizabeth Hospital
5011
Woodville
S.A.
Australia
Abstract
The etiology of ulcerative colitis remains unresolved despite new immunologic, biochemical, and microbiologic observations made in this disease. A sequence of pathogenetic events has been adduced from abnormalities reported from human and experimental colitis with the express purpose of establishing priority of factors that may lead to an attack of acute ulcerative colitis. The presence of undefined bacterial metabolites in the colonic lumen causing specific breadown of fatty acid oxidation in colonic epithelial cells is proposed to be the initiating event of the disease process that leads to an immune response and eicosanoid response perpetuating epithelial cell damage. The proposals embody the thesis that primary metabolic damage to colonocytes determines the clinical and pathologic manifestations of ulcerative colitis.
© The ASCRS 1988