New insights in the pathogenesis and in the management of Pediatric Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a world- wide health-care problem with a continually increasing incidence. The exact cause of IBD is still unknown, but is thought to be due to a combination of patient's genetics, microbiome, immune response, and the environment that result in an excessive and abnormal immune response against commensal flora in genetically susceptible individuals. Therefore the main aims of my thesis are deepen the knowledge of IBD pathogenesis investigating genetic susceptibility and its functional implication in pediatric inflammatory bowel disease, as well as describing peculiar clinical phenotype. Moreover, I propose new therapeutic strategies for the treatment of the disease. A true understanding of IBD pathogenesis is mandatory to improve current therapeutic approaches to IBD. There is no doubt that there has been an enormous improvement in the management of IBD, however results are far from ideal, particularly in regard to rather predictable recurrence of disease. Since IBD is the result of a complex integration of different components, an effective therapy can only be achieved if an IBD integrated approach is implemented. Hopefully, the collection of large amounts of molecular data from genomic, proteomic, and microbiomic arrays could generate models that could improve patient classifications, predict clinical course, select the most logical treatment forms, and anticipate outcome.