Is the emergence of inflammatory bowel disease a prime example of “the third epidemiological transition”?

Excerpt

Inflammatory bowel disease (IBD) burden is increasing at a rapid pace in India and other Asian countries and with total population into consideration, India is projected to have among the highest IBD burden across the globe, despite having lower prevalence as compared to the West [1, 2]. Although the IBD genetic architecture of India and West exhibits both similarities and differences, the overall genetic risk of Indians is like that in the West as demonstrated by the similar susceptibility to disease in second-generation Indian immigrants living in high prevalence areas [2]. The microbiota signature of Indian IBD patients is also similar as shown by matching perturbations in the structural and functional component of gut microbiota in Indian studies [3, 4]. While the incidence and prevalence of IBD have stabilized in North America and Europe [5], both continue to rise in low-incidence regions such as Eastern Europe, Africa, and Eastern and Southern Asia [2, 6]. This changing epidemiology of IBD over time and geography suggests that environmental factors play a major role in pathogenesis. The present study by Amarapurkar et al. [7] is a laudable effort at understanding the epidemiological risk factors for IBD in developing countries, which would further translate into a comprehensive network of IBD interactome, and hence improve our understanding of the possible reasons for the emergence of this disease into this side of the globe. …