Published online Jul 31, 2019. doi: 10.13105/wjma.v7.i7.346
Peer-review started: July 21, 2019
First decision: July 23, 2019
Revised: July 25, 2019
Accepted: July 29, 2019
Article in press: July 29, 2019
Published online: July 31, 2019
Processing time: 12 Days and 0.6 Hours
Cytomegalovirus (CMV) is frequently detected in inflammatory bowel tissue, especially in corticosteroid-refractory patients, and it has been blamed for adverse outcomes. However, the first acquisition of CMV does not involve the colon. In particular in the colonic mucosa, which evolved due to the gut microbial relationship, CMV promotes inflammation via recruited monocytes and not through replication in resident macrophages. Whether CMV is the last straw in the process of mucosal inflammation, a doomed agent, or an innocent bystander is a difficult question that remains elusive. With this work, we will try to review the relationship between intestinal mucosa and CMV in the framework of basic virological principles.
Core tip: We will here draw an analogy between the cytomegalovirus and the hero of the Gaston Leroux’s “The Phantom of the Opera” novel, with the intestinal mucosa as the opera building. We aimed to emphasize the viral pathogenesis process to understand the elusive character of cytomegalovirus in the inflammatory bowel diseases.