Immunological Aspects of the Liver and Gastrointestinal Tract

Springer Science & Business Media
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We have been privileged to start our academic careers at the begin ning of the decade in which the immunological roles and hypersensitivity diseases of the gastrointestinal tract and liver have been defined. In the early 1960s IgA was reported to be the main secretory immunoglobulin, immunoblasts were shown to home to the intestinal mucosa and certain serum autoantibodies were described in patients with chronic liver disease. Shortly thereafter IgE and Australia antigen were discovered. Parallel advances in clinical investigation, in particular closed biopsy techniques, facilitated correlation of morphological changes with im munological mechanisms in disease of the gastrointestinal tract and liver. Only 10 years later, the concepts of immunity and hypersensitivity are regularly applied to the pathogenesis, diagnosis, treatment and prog nosis of many chronic diseases in these organs. In designing this book we have attempted to integrate theorectical and clinical immunology as they pertain in 1975; our ultimate aim is aptly described by Brachet as quoted by Professor Paronetto (page 319). We would like to think that this review provides a basis for the next major advances in the fields of gastrointestinal and hepatic immunology. As we see it, the outstanding problem in both sites is how to produce protective immunity without hypersensitivity.
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Springer Science & Business Media
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Published on
Dec 6, 2012
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Medical / Clinical Medicine
Medical / Gastroenterology
Medical / Hepatology
Medical / Immunology
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In der letzten Auflage des Handbuchs der inneren Medizin aus dem Jahre 1953 wurden im Rahmen der Abhandlung der Verdauungskrankheiten dem Dünn- und Dickdarm von NORBERT HENNING und W. BAUMANN insgesamt 270 Seiten gewidmet. Nach 30 Jahren haben unsere Kenntnisse über Funktion, Pathophysiologie, Ätiologie, Pathogenese, Diagnostik und Therapie von Er krankungen des Dünndarmes so erheblich zugenommen, daß den Erkrankungen des Dünndarmes ein eigener Doppelband gewidmet werden mußte. Der Dünndarm hat eine zentrale Stellung nicht nur in der Assimilation von Nahrungsstoffen, sondern spielt auch eine wichtige Rolle als Immunorgan, ist inzwischen zu einem der größten hormonproduzierenden Organ geworden, Sekretionsmechanismen sind von eminenter Bedeutung bei Diarrhöen, der Dünndarm spielt eine wichtige Rolle im Lipidstoffwechsel. Die Gliederung und Zusammenstellung des Bandes basiert auf zwei Prinzi pien, die vom Herausgeber als wesentlich erachtet werden: 1. Die Qualität der praktischen Medizin ist abhängig vom Verständnis medi zinisch-wissenschaftlicher Grundlagen, denn Fortschritte in der klinischen Medi zin basieren fast immer auf wissenschaftlicher Grundlage. 2. Krankheiten oder Störungen physiologischer Zustände sollten kritisch betrachtet werden, bevor über sie einer professionellen Leser- oder Zuhö rerschaft berichtet wird. Langerwiesene Konzepte der Pathogenese und Therapie müssen immer wie der neu und kritisch auf ihre Gültigkeit geprüft werden. Besonderer Wert wurde deshalb vom Herausgeber auf die profunde Erarbei tung pathophysiologischer Grundlagen gelegt, die Voraussetzung sind für eine rationale Diagnostik und Therapie.
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