Environmental triggers in IBD: a review of progress and evidence
Abstract
A number of environmental factors have been associated with the development of IBD. Alteration of the gut microbiota, or dysbiosis, is closely linked to initiation or progression of IBD, but whether dysbiosis is a primary or secondary event is unclear. Nevertheless, early-life events such as birth, breastfeeding and exposure to antibiotics, as well as later childhood events, are considered potential risk factors for IBD. Air pollution, a consequence of the progressive contamination of the environment by countless compounds, is another factor associated with IBD, as particulate matter or other components can alter the host's mucosal defences and trigger immune responses. Hypoxia associated with high altitude is also a factor under investigation as a potential new trigger of IBD flares. A key issue is how to translate environmental factors into mechanisms of IBD, and systems biology is increasingly recognized as a strategic tool to unravel the molecular alterations leading to IBD. Environmental factors add a substantial level of complexity to the understanding of IBD pathogenesis but also promote the fundamental notion that complex diseases such as IBD require complex therapies that go well beyond the current single-agent treatment approach. This Review describes the current conceptualization, evidence, progress and direction surrounding the association of environmental factors with IBD.
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- Authors
- Ananthakrishnan, A. N., Bernstein, C. N., Iliopoulos, D., Macpherson, A., Neurath, M. F., Ali, R. A. R., Vavricka, S. R., & Fiocchi, C.
- Affiliations
- Harvard University (US)
- University of Manitoba (CA)
- University of California, Los Angeles (US)
- University Hospital of Bern (CH)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- University Kebangsaan Malaysia Medical Centre (MY)
- Triemli Hospital (CH)
- Cleveland Clinic (US)
- Corresponding author
- Ananthakrishnan, Ashwin N.
- ORCID
- Venue
- Nature Reviews Gastroenterology & Hepatology
- Published
- 2017-10-11
- Volume
- 15
- Issue
- 1
- Pages
- 39-49
- ISSN
- 1759-5045 (ISSN-L)
- 1759-5053
- OpenAlex
- W2764244742
- Cited by
- 948
- References
- 104
- Citations by year
- 2026: 87 · 2025: 141 · 2024: 147 · 2023: 132 · 2022: 132 · 2021: 114 · 2020: 87 · 2019: 78 · 2018: 27 · 2017: 1 · 2016: 1 · 2015: 1
- FWCI
- 6.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Gastroenterology & Hepatology (publishedVersion)
- PubMed (publishedVersion)
- BORIS (University Library Bern) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- inflammatory bowel disease, environmental risk factors, gut microbiota, dysbiosis, diet, pollution, air pollution, particulate matter, early life exposure, breastfeeding, antibiotic exposure, high altitude, hypoxia, IBD flare, mucosal immunity, systems biology, IBD pathogenesis
- MeSH terms
- Environment, Humans, Risk Factors, Socioeconomic Factors, Inflammatory Bowel Diseases
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