Pathogenetic factors of ulcerative colitis: mainstream for 2020

The causes of ulcerative colitis are still unknown. Scientists made important advances in understanding the pathogenesis of this disease in the 21st century. Complex involvement of an impaired immune response in relation to antigens of the intestinal microbiota in genetically predisposed individuals under the influence of certain environmental factors was revealed. The factors that disrupt the epithelial barrier and alter the composition of the intestinal microbiota trigger the onset of the disease, thereby stimulating an impaired immune response. Recent studies have discovered completely new hypotheses of its origin and development, gradually interpreting the already known pathogenetic mechanisms of the disease. In this review, we focused on the new concepts in the pathogenesis of ulcerative colitis. We examined genetic, environmental, barrier, and microbial factors. We went into detail on the structure and role of the epithelial barrier, identified specific genes that are involved in the regulation of the intestinal epithelial barrier function in ulcerative colitis. We studied the literature containing information on relevant studies in PubMed and Google Scholar citation systems, using such key words as ulcerative colitis, colon microbiota, barrier function, genetic predisposition, and predisposing factors