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Immunologic Regulation of Health and Inflammation in the Intestine

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Pediatric Inflammatory Bowel Disease

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Abstract

A majority of the human immune system is found in close association with the gastrointestinal tract and is organized in dense complex structures that encompass numerous sophisticated cellular interactions. A properly functioning mucosal immune system is necessary to protect from pathogen entry or colonization, while also establishing tolerance to dietary stimuli or the trillions of normally beneficial microbes that inhabit the intestine, termed the microbiota. This involves a balancing act and many regulatory pathways, which if disrupted, results in chronic overactivation of the mucosal immune system and is a defining feature of inflammatory bowel disease (IBD). In this chapter, we review our current understanding of how the mucosal immune system orchestrates states of health and inflammation in the mammalian gastrointestinal tract, building off of knowledge obtained from basic pre-clinical models and translational patient-based studies. Further, we discuss unique features of mucosal immunity in children and fundamental gaps in knowledge surrounding our understanding of the immune response in the pathogenesis of IBD.

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Authors and Affiliations

  1. Joan and Sanford I. Weill Department of Medicine, Division of Gastroenterology & Hepatology, Weill Cornell Medicine, Cornell University, New York, NY, USA

    Anees Ahmed & Gregory F. Sonnenberg

  2. Department of Microbiology and Immunology, Weill Cornell Medicine, Cornell University, New York, NY, USA

    Anees Ahmed & Gregory F. Sonnenberg

  3. Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA

    Anees Ahmed & Gregory F. Sonnenberg

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  1. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Petar Mamula

  2. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Judith R. Kelsen

  3. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Andrew B. Grossman

  4. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Robert N. Baldassano

  5. Division of Pediatric Gastroenterology, Prisma Health Children’s Hospital—Upstate, Greenville, SC, USA

    Jonathan E. Markowitz

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Ahmed, A., Sonnenberg, G.F. (2023). Immunologic Regulation of Health and Inflammation in the Intestine. In: Mamula, P., Kelsen, J.R., Grossman, A.B., Baldassano, R.N., Markowitz, J.E. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-031-14744-9_2

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