Local immune response in inflammatory bowel disease

The main element in the pathogenesis of inflammatory bowel diseases, including Crohn's disease and ulcerative colitis, is impaired immune regulation. The maintenance of homeostasis and the formation of an immune response to damaging factors are controlled by the interaction of numerous cells that form the lymphoid tissue associated with the intestinal mucosa. This review considers the main cellular and non-cellular mechanisms of development and maintenance of chronic inflammatory process in the intestine, as well as the prospects for improving diagnostic and therapeutic tactics in patients with Crohn's disease and ulcerative colitis. The most important cells of the intestinal barrier include enterocytes, Paneth cells, bocaloid, dendritic and microvessel cells, neutrophils, macrophages, plasma cells and T-lymphocytes. Dysfunction of each of these cell types, including impaired synthesis of their products – cytokines, defensins and chemokines, leads to increased permeability of the intestinal wall, development of local inflammatory response and formation of mucosal defects. A promising direction in the diagnosis and treatment of inflammatory bowel diseases is to assess the diagnostic significance of determining the level of cytokines in coprofiltrate for noninvasive personalised monitoring of disease activity and the effectiveness of therapy. Key words: Crohn's disease, inflammatory bowel disease, local immunity, cytokines, ulcerative colitis