Introduction

Rosacea Free Forever

Rosacea Free Forever Cure By Laura Taylor

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Crohn's disease is a chronic relapsing inflammatory condition of the gastrointestinal tract, leading to transmural ulceration of any part of the bowel with associated stricturing and fistula formation (Fig. 1). The spectrum of disease is vast, thus patients may present with abdominal pain, bloody diarrhoea, weight loss, peri-anal sepsis, malabsorption or one of many systemic manifestations such as liver, skin or joint disease.1 In all cases there is evidence of systemic immune activation such as raised inflammatory markers, pyrexia and a peripheral leucocytosis. Intestinal inflammation in Crohn's disease is associated with a vast increase in the activity of the mucosal immune system.2 Thus, increased numbers of monocytes, macrophages, lymphocytes and neutrophils secrete lipid mediators (eicosonoids, and platelet activating factor) and both reactive oxygen and nitrogen metabolites, which lead to tissue destruction. The influx of leukocytes from the peripheral circulation is orchestrated by increased expression of adhesion molecules on the vascular endothelium and the production of cytokines and chemokines within the mucosa (Fig. 2).3 No single etiological factor has been identified; thus it is postulated that the intestinal inflammation associated with Crohn's disease results from a combination of genetic and environmental factors leading to a persistent Th1 lymphocyte mediated immune response driven by a loss of tolerance to commensal enteric bacteria.1,4,5 In addition, recent evidence has suggested that genetic defects within the innate immune system's response to luminal bacteria may play a role in the initiation of the disease.6 Animal models in which IL-10 signalling is disrupted highlight the crucial role that IL-10 plays in the regulation of mucosal

Figure 1. The features of Crohn's disease. A) A colonoscopic view of the mucosa of a patient with active Crohn's disease illustrating snail track ulceration, mucosal erythema and stricture formation. B) A double contrast barium enema demonstrates pseudosaculations of the colon (arrow heads) and strictured segments (arrow) in another patient with active disease.

Figure 1. The features of Crohn's disease. A) A colonoscopic view of the mucosa of a patient with active Crohn's disease illustrating snail track ulceration, mucosal erythema and stricture formation. B) A double contrast barium enema demonstrates pseudosaculations of the colon (arrow heads) and strictured segments (arrow) in another patient with active disease.

immune responses.7,8 This chapter focuses on the role of IL-10 in intestinal inflammation and explores its potential as a therapy for Crohn's disease.

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