Although the disorder is quite common, its exact pathogenesis is not fully understood however, it is known that UC is connected with the excessive immune response to the environmental factors or resident microbiota among genetically susceptible subjects, and the immunity status plays a crucial role in the increased intestinal permeability and impaired barrier function, as presented graphically in Figure 1. The most common clinical symptoms are gastrointestinal disorders such as abdominal pain, diarrhea with mucus and/or blood, nausea and vomiting nevertheless, general symptoms including fever, weight loss and anemia are also observed with the parenteral symptoms-peripheral arthritis, cholangitis, pyoderma gangrenosum, erythema nodosum and arthropathies. Changes observed within the intestinal mucosa are localized in the rectum and spread proximally to the other parts of the colon. Inflammation of the colon mucosa plays an essential role in pathogenesis of UC, which leads to ulcer formation. Characteristic of UC are alternating periods of clinical relapse and remission. The condition is diagnosed mostly between the ages of 20 to 40, however it can occur at every age. Ulcerative colitis (UC) is a chronic inflammatory disease, which belongs with Crohn’s disease to the group of the inflammatory bowel diseases (IBDs). Our knowledge of the involvement of the immune system in the pathophysiology of IBD has advanced rapidly over the last two decades, leading to the development of several immune-targeted treatments with a biological source, known as biologic agents. It included systematic reviews, meta-analyses and clinical trials. The review is based on personal selection of literature that were retrieved by a selective search in PubMed using the terms “ulcerative colitis” and “pathogenesis of ulcerative colitis”. This review briefly describes the current state of knowledge about the involvement of the innate and adaptive immune systems in the pathogenesis of UC. Additionally, the impact of cytokines on shaping the immune response as well as sustaining inflammation seems to be crucial. Due to the presence of antibodies directed against resident microbiota or one’s own tissues, the influence of B lymphocytes on the development of UC is also highlighted. On the other hand, mechanisms of the adaptive immune response involve cells such as: cytotoxic lymphocytes, regulatory lymphocytes Treg, or helper lymphocytes Th–Th2, Th9, Th17, Th22, among which significant discoveries about Th9 and Th17 lymphocytes have been made in recent years. In the case of innate immune response cells, neutrophils, dendritic cells, macrophages have a crucial impact on the development of the disease, as well as innate lymphoid cells, which have received a particular attention in recent years. Both innate and adaptive immune cells play a crucial role in the pathogenesis of UC. Ulcerative colitis (UC) is a chronic inflammatory disease with an underlying excessive immune response directed against resident microbiota and/or dietary antigens.
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