Luís Martins | Universidade Fernando Pessoa (original) (raw)

Papers by Luís Martins

Crohn's disease is a relapsing systemic infl ammatory disease, mainly aff ecting the gastrointest... more Crohn's disease is a relapsing systemic infl ammatory disease, mainly aff ecting the gastrointestinal tract with extraintestinal manifestations and associated immune disorders. Genome wide association studies identifi ed susceptibility loci that-triggered by environmental factors-result in a disturbed innate (ie, disturbed intestinal barrier, Paneth cell dysfunction, endoplasmic reticulum stress, defective unfolded protein response and autophagy, impaired recognition of microbes by pattern recognition receptors, such as nucleotide binding domain and Toll like receptors on dendritic cells and macrophages) and adaptive (ie, imbalance of eff ector and regulatory T cells and cytokines, migration and retention of leukocytes) immune response towards a diminished diversity of commensal microbiota. We discuss the epidemiology, immunobiology, amd natural history of Crohn's disease; describe new treatment goals and risk stratifi cation of patients; and provide an evidence based rational approach to diagnosis (ie, work-up algorithm, new imaging methods [ie, enhanced endoscopy, ultrasound, MRI and CT] and biomarkers), management, evolving therapeutic targets (ie, integrins, chemokine receptors, cell-based and stem-cell-based therapies), prevention, and surveillance.

Crohn's disease is a relapsing systemic infl ammatory disease, mainly aff ecting the gastrointest... more Crohn's disease is a relapsing systemic infl ammatory disease, mainly aff ecting the gastrointestinal tract with extraintestinal manifestations and associated immune disorders. Genome wide association studies identifi ed susceptibility loci that-triggered by environmental factors-result in a disturbed innate (ie, disturbed intestinal barrier, Paneth cell dysfunction, endoplasmic reticulum stress, defective unfolded protein response and autophagy, impaired recognition of microbes by pattern recognition receptors, such as nucleotide binding domain and Toll like receptors on dendritic cells and macrophages) and adaptive (ie, imbalance of eff ector and regulatory T cells and cytokines, migration and retention of leukocytes) immune response towards a diminished diversity of commensal microbiota. We discuss the epidemiology, immunobiology, amd natural history of Crohn's disease; describe new treatment goals and risk stratifi cation of patients; and provide an evidence based rational approach to diagnosis (ie, work-up algorithm, new imaging methods [ie, enhanced endoscopy, ultrasound, MRI and CT] and biomarkers), management, evolving therapeutic targets (ie, integrins, chemokine receptors, cell-based and stem-cell-based therapies), prevention, and surveillance.