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Nonspecific ulcerative colitis - Causes.
Last reviewed: 04.07.2025
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For decades, intensive searches have been underway for mechanisms of development common to and specific to only one of these diseases.
The infectious theory is of the greatest interest. And this is quite understandable, since the inflammatory nature of nonspecific ulcerative colitis gave grounds to assume that some specific pathogen is involved in the occurrence and development of the pathological process. It was suggested that nonspecific ulcerative colitis may be caused by viruses, bacteria or their metabolic products. In later works, L-forms of small intestinal bacteria (Chlamidia, Str. faecalis) were considered as a causative factor of nonspecific ulcerative colitis. Research in this direction is currently ongoing, but attempts to identify a specific pathogen have not been successful so far.
Chronic course of nonspecific ulcerative colitis, tendency to seasonal exacerbations, pronounced systemic manifestations, positive effect of hormonal therapy suggested the participation of immune mechanisms in the development of these diseases. In this regard, the immune status of patients was repeatedly studied. Clinical and immunological comparisons were carried out, which showed that with increasing severity of the process in the gastrointestinal tract, changes in the immunological status worsen. Local changes in IgA subclasses were revealed in nonspecific ulcerative colitis with localization of the process in the large intestine. The assumption about the participation of endotoxins in the pathophysiological mechanisms of both diseases entailed a study to determine lipid A antibodies (ALA), which is a component of endotoxins of gram-negative bacteria, in the blood serum.
An analysis of literature data shows that, despite the complexity and versatility of studies on the immunological status of patients with nonspecific ulcerative colitis, the authors strive to find answers to 3 main questions:
- Do immunological mechanisms participate in the occurrence and development of these diseases?
- Can autoimmune reactions that occur during ulcerative colitis provide clues to the causes of these diseases?
- whether immunological factors influence certain groups of people, making them susceptible to ulcerative colitis.
In order to answer the question of whether nonspecific ulcerative colitis is a classic genetic disease, HLA phenotypes were studied in patients, their relatives, and control group individuals. The results confirmed the data of previous studies that nonspecific ulcerative colitis cannot be classified as a typical genetic disease.
Thus, despite numerous studies of various genetic, immunological, microbial, psychogenic and environmental factors, the cause of nonspecific ulcerative colitis has not yet been established. It is unclear whether these diseases are different nosological forms or whether they represent different manifestations of the same disease. Apparently, all of the above factors may be important in the multifactorial model of their etiology and pathogenesis. The most currently recognized theory of the origin of nonspecific ulcerative colitis points to the leading role of intestinal antigens, the impact of which is accompanied by a change in immune reactivity and intestinal inflammation. It is assumed that the reactivity of the body is also affected by genetic factors that have not yet been studied well.
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