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Mechanisms of Disease: nicotine—a review of its actions in the context of gastrointestinal disease

Nature Clinical Practice Gastroenterology & Hepatology volume 2, pages 536–544 (2005)Cite this article

Abstract

Smoking tobacco is associated with a number of gastrointestinal disorders. In some, such as Crohn's disease and peptic ulcer disease, it increases the risk of disease and has a detrimental effect on their course. In others, such as ulcerative colitis, it decreases the risk of disease and can have a favorable effect on disease course and severity. In the eighteenth and nineteenth centuries, nicotine was used as a 'panacea' for various ailments, including abdominal symptoms—it is now under investigation to elucidate its role in gastrointestinal diseases that are associated with smoking. The actions of nicotine are complex; it is likely that its effects on the central nervous system, gastrointestinal tract and immune system interact with other risk factors, such as genetic susceptibility, to influence disease outcomes. This review focuses on the mechanisms of action of nicotine that might be relevant in gastrointestinal disease.

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Figure 1: Proposed mechanism by which nicotine and smoking might influence the risk of a susceptible individual towards developing either ulcerative colitis or Crohn's disease.

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Author information

Authors and Affiliations

  1. Consultant Gastroenterologist Department of Gastroenterology, at the University Hospital of Wales, Cardiff, UK

    Gareth AO Thomas

  2. Professor emeritus Department of Gastroenterology, at the University Hospital of Wales, Cardiff, UK

    John Rhodes

  3. doctor in the Department of Gastroenterology, at the University Hospital of Wales, Cardiff, UK

    John R Ingram

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  1. Gareth AO Thomas
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  2. John Rhodes
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Correspondence to Gareth AO Thomas.

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Competing interests

The authors have, in the past, received financial support from SLA Pharma and Kabi Pharmacia for some of their work on nicotine and inflammatory bowel disease.

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Thomas, G., Rhodes, J. & Ingram, J. Mechanisms of Disease: nicotine—a review of its actions in the context of gastrointestinal disease. Nat Rev Gastroenterol Hepatol 2, 536–544 (2005). https://doi.org/10.1038/ncpgasthep0316

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