Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease
Pulmonary manifestation (PM) of inflammatory bowel disease (IBD) in children is a rare condition. The exact pathogenesis is still unclear, but several explanatory concepts were postulated and several case reports in children were published. We performed a systematic Medline search between April 1976...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/23/13/7287 |
| _version_ | 1797479602869764096 |
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| author | Florian Schmid Cho-Ming Chao Jan Däbritz |
| author_facet | Florian Schmid Cho-Ming Chao Jan Däbritz |
| author_sort | Florian Schmid |
| collection | DOAJ |
| description | Pulmonary manifestation (PM) of inflammatory bowel disease (IBD) in children is a rare condition. The exact pathogenesis is still unclear, but several explanatory concepts were postulated and several case reports in children were published. We performed a systematic Medline search between April 1976 and April 2022. Different pathophysiological concepts were identified, including the shared embryological origin, “miss-homing” of intestinal based neutrophils and T lymphocytes, inflammatory triggering via certain molecules (tripeptide proline-glycine-proline, interleukin 25), genetic factors and alterations in the microbiome. Most pediatric IBD patients with PM are asymptomatic, but can show alterations in pulmonary function tests and breathing tests. In children, the pulmonary parenchyma is more affected than the airways, leading histologically mainly to organizing pneumonia. Medication-associated lung injury has to be considered in pulmonary symptomatic pediatric IBD patients treated with certain agents (i.e., mesalamine, sulfasalazine or infliximab). Furthermore, the risk of pulmonary embolism is generally increased in pediatric IBD patients. The initial treatment of PM is based on corticosteroids, either inhaled for the larger airways or systemic for smaller airways and parenchymal disease. In summary, this review article summarizes the current knowledge about PM in pediatric IBD patients, focusing on pathophysiological and clinical aspects. |
| first_indexed | 2024-03-09T21:49:05Z |
| format | Article |
| id | doaj.art-945f24bf9f574d3a817daabaa17a934a |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-09T21:49:05Z |
| publishDate | 2022-06-01 |
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| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-945f24bf9f574d3a817daabaa17a934a2023-11-23T20:11:14ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672022-06-012313728710.3390/ijms23137287Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel DiseaseFlorian Schmid0Cho-Ming Chao1Jan Däbritz2Catholic Children’s Hospital Wilhelmstift, 22149 Hamburg, GermanyDepartment of Pediatrics, University Medical Center Rostock, 18057 Rostock, GermanyDepartment of Pediatrics, University Medical Center Greifswald, 17475 Greifswald, GermanyPulmonary manifestation (PM) of inflammatory bowel disease (IBD) in children is a rare condition. The exact pathogenesis is still unclear, but several explanatory concepts were postulated and several case reports in children were published. We performed a systematic Medline search between April 1976 and April 2022. Different pathophysiological concepts were identified, including the shared embryological origin, “miss-homing” of intestinal based neutrophils and T lymphocytes, inflammatory triggering via certain molecules (tripeptide proline-glycine-proline, interleukin 25), genetic factors and alterations in the microbiome. Most pediatric IBD patients with PM are asymptomatic, but can show alterations in pulmonary function tests and breathing tests. In children, the pulmonary parenchyma is more affected than the airways, leading histologically mainly to organizing pneumonia. Medication-associated lung injury has to be considered in pulmonary symptomatic pediatric IBD patients treated with certain agents (i.e., mesalamine, sulfasalazine or infliximab). Furthermore, the risk of pulmonary embolism is generally increased in pediatric IBD patients. The initial treatment of PM is based on corticosteroids, either inhaled for the larger airways or systemic for smaller airways and parenchymal disease. In summary, this review article summarizes the current knowledge about PM in pediatric IBD patients, focusing on pathophysiological and clinical aspects.https://www.mdpi.com/1422-0067/23/13/7287childrenmolecularinflammationimmunitygut–lung axisairways |
| spellingShingle | Florian Schmid Cho-Ming Chao Jan Däbritz Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease International Journal of Molecular Sciences children molecular inflammation immunity gut–lung axis airways |
| title | Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease |
| title_full | Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease |
| title_fullStr | Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease |
| title_full_unstemmed | Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease |
| title_short | Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease |
| title_sort | pathophysiological concepts and management of pulmonary manifestation of pediatric inflammatory bowel disease |
| topic | children molecular inflammation immunity gut–lung axis airways |
| url | https://www.mdpi.com/1422-0067/23/13/7287 |
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