MEDICAL THERAPY FOR INFLAMMATORY BOWEL DISEASE

https://doi.org/10.1016/S0889-8553(05)70058-3Get rights and content
Under a Creative Commons license
open archive

Crohn's disease (CD) and ulcerative colitis (UC) comprise a series of idiopathic and heterogeneous inflammatory disorders resulting from chronic up-regulation of the enteric mucosal immune system.53, 63 Although an exact etiopathogenesis of inflammatory bowel disease (IBD) remains elusive, it appears that there is chronic activation of the immunoinflammatory cascade in genetically susceptible individuals resulting in chronic mucosal damage.

The therapeutic modalities used to treat IBD act at various locations along immune and inflammatory pathways. Although traditional therapies, such as aminosalicylates and corticosteroids, continue to be cornerstones in the management of IBD, immunomodulators, such as azathioprine and 6-mercaptopurine (6-MP), are demonstrating increasing importance in the setting of steroid-resistant and steroid-dependent disease. Further, postoperative prophylaxis with certain antibiotics (e.g., metronidazole), aminosalicylates, or immunomodulators may be beneficial in the prevention of recurrence in some CD patients after resection. In addition, immunosuppressive agents previously reserved for organ transplantation (e.g., cyclosporine) have expanded the armamentarium of medical therapies as advances in molecular engineering techniques are already heralding development of a novel class of biologic therapies available for certain subgroups of patients.

Cited by (0)

Address reprint requests to Robert B. Stein, MD, University of Pennsylvania Health System, Presbyterian Medical Center, 39th and Market Streets, Suite W218, Philadelphia, PA 19104