Because of restrictions on length we could not cite all relevant publications. We selected primary reports if they lent support to a specific aspect of the hypothesis, and review articles were chosen if they provided a concise overview of concepts for a general audience.
ReviewHoming of mucosal lymphocytes to the liver in the pathogenesis of hepatic complications of inflammatory bowel disease
Section snippets
Tissue tropism and lymphocyte recirculation
Lymphocyte homing was first shown by Gowans and Knight,8 who reported that activated immunoblasts (memory or effector cells) recirculate to mucosal sites, whereas small lymphocytes (naïve cells) return to lymphoid organs. Naïve T cells emerge into the bloodstream from the thymus, where they are selected by their ability to discriminate between foreign and self-antigens.9 The naïve T cells circulate between the blood and secondary lymphoid organs—eg, lymph nodes—which they enter by binding to
Eye and joint extraintestinal manifestations
In some people with inflammatory bowel disease, leucocytes infiltrate the joints, eyes, skin, or liver, and extraintestinal complications arise.6, 51, 52 The finding that mucosal immunoblasts from people with inflammatory bowel disease bind well to peripheral lymph node venules gave rise to the concept that extraintestinal inflammation is mediated by lymphocytes that have been activated in the gut and subsequently home aberrantly to these other sites.53 Extraintestinal complications that arise
Conclusions
Lymphocyte recirculation and homing under normal conditions, and recruitment to tissues during inflammation, are distinct but interrelated processes. Homing is a continuous physiological process, in which memory T cells recirculate through the tissue in which they were originally activated as part of the process of immune surveillance. The tissue tropism of the lymphocyte is ascertained by expression of adhesion molecules and chemokine receptors on the lymphocyte, which allow it to recognise
Search strategy and selection criteria
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