The vasculature and inflammatory bowel disease - Contribution to pathogenesis and clinical pathology

Data from complementary lines of investigation have demonstrated that the vasculature plays an important role in the pathogenesis and clinical course of IBD (see Table 1). The systemic circulation as well as the local intestinal vasculature are both affected by IBD, because patients are hypercoagulable and at risk for thrombosis. In response to the stress of chronic inflammation, patients demonstrate an impaired vascular perfusion, which is linked to impaired endothelial generation of NO in the microvascular endothelium. Likewise, local endothelial populations in chronically inflamed IBD intestine demonstrate altered patterns of leukocyte recruitment, with preferential adhesion of naive leukocytes. Finally, novel strategies targeting endothelial-leukocyte interaction are emerging as potent biologic therapies for patients with refractory IBD. Copyright © 2005 by Lippincott Williams & Wilkins.