Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
ISSN: 2161-0665
Aaron Lerner and Torsten Matthias
Technion-Israel Institute of Technology, Israel
AESKU KIPP Institute, Germany
Posters & Accepted Abstracts: Pediat Therapeut
Objectives & Study: In suitable circumstances, the human gut possesses all the components necessary to start the autoimmune cascade. The aim of the study was to characterize the multiple gut-remote organ autoimmune axes. Methods: A systematic review was performed to identify studies referred to gut-gut, brain, joint, bone, endocrine, kidney, lung, liver, heart and skin exes using Medline, Google and Cochrane Library databases. Results: The specific dysbiota and tight junction dysfunction seems to be a primary defect in autoimmune diseases. Intestinal permeability is decreased in many: Ulcerative colitis, Crohn��?s disease, celiac disease, inflammatory joint disease, ankylosing spondylitis, juvenile onset arthritis, psoriatic arthritis, type 1 diabetes mellitus and primary biliary cirrhosis. The end result of the passage of those non-self- proteins, from the luminal compartment to the sub epithelial one, initiates the autoimmune cascade. The richness of the mucosal milieu in immune components, cells and systems; blood and lymphatic vessels; entero-neuronal and endocrine network; and mural endo-mesoderm cohabitation constitute an ideal place to initiate, maintain and propagate the autoimmune process. The mucosal committed immune cells, post translation modified proteins, proinflammatory cytokines and lymphokines have the capacity to circulate via the local vessels, to bring the autoimmune message to remote organs, thus creating gut-extra intestinal organ axes of autoimmunity. Each one of the remote organs: Brain, joint, bone, endocrine, kidney, lung, liver, heart and skin, is directionally relayed to the intestinal events taking place in the genetically susceptible individuals Conclusions: The immune system carefully distinguishes between self and non-self-components. The intestine is a major site of changing tolerance to autoimmunity. The disease specific dysbiota, its post translational capacity to modify proteins, the plethora of substrates, the leaky gut, the local adjacent immune, neuroendocrine, vascular and lymphatic systems make the intestine a prime candidate to drive systemic autoimmunity
Email: aaronlerner1948@gmail.com