Immunosuppression in Inflammatory Bowel Diseases: Standards, New Developments, Future TrendsK. Fellermann, D.P. Jewell, W.J. Sandborn, J. Schölmerich, E.-F. Stange The aetiology of the chronic inflammatory bowel diseases - Crohn's disease and ulcerative colitis - is still enigmatic. The therapeutic approach has therefore traditionally focused on anti-inflammatory principles, including corticosteroids and aminosalicylates. Since a significant proportion of patients is steroid-dependent or refractory and because of the problematic side-effects of long-term systemic steroids, active immunosuppression has gained acceptance in the field. The classical immunosuppressants azathioprine and 6-mercaptopurine have long been evidence-based in IBD, but underused. Recently, methotrexate and cyclosporine have also been proven to be effective in certain situations. Newer drugs like tacrolimus, mycophenolate and others may be similarly useful but their potential is still unclear. Finally, the immune modifiers including IL-10 and TNF-antibodies have been successfully subjected to controlled trials. Other experimental drugs discussed in this book are on the horizon. This volume is the Proceedings of Falk Symposium 119 held in Freiburg-im-Breisgau, Germany, October 3-4, 2000, and covers systematically the field of immunosuppression in inflammatory bowel diseases. It is hoped that it will further the prudent use of these drugs in the proper clinical situations by increasing our understanding of both the mechanisms of action and the clinical benefit to the patient. |
Contents
II | 3 |
III | 11 |
IV | 18 |
V | 25 |
VI | 37 |
VIII | 47 |
X | 52 |
XII | 64 |
XXXIV | 143 |
XXXVI | 149 |
XXXVII | 157 |
XXXIX | 164 |
XLI | 173 |
XLIII | 179 |
XLV | 185 |
XLVI | 191 |
XIV | 87 |
XV | 97 |
XVII | 102 |
XIX | 109 |
XXII | 113 |
XXV | 122 |
XXVIII | 127 |
XXX | 131 |
XXXI | 138 |
XLVII | 201 |
L | 207 |
LI | 212 |
LIII | 215 |
LIV | 223 |
LVI | 233 |
LVIII | 236 |
LX | 239 |
Common terms and phrases
6-mercaptopurine acid active Crohn's disease antibody antigen apoptosis azathioprine binding Biol cancer CD4+ CDAI chronic active Clin colonic controlled trial corticosteroids Crohn's disease cyclosporin cytokine defensin demonstrated disease activity disease and ulcerative dose drug effective efficacy enemas Engl epithelial cells expression Falk Symposium fistulas function g/day Gastroenterol Gastroenterology gene genetic glucocorticoid receptor human immune Immunol immunosuppressive increased induced inflammatory bowel disease infliximab inhibition intravenous ISBN lamina propria levels Liver long-term LP-T cells lymphocytes lymphoma mechanisms mesalazine methotrexate mice molecules mucosal mycophenolate mofetil necrosis factor oral pathway patients with Crohn's patients with IBD Pediatr Pharmacol placebo prednisone pregnancy Present DH protein randomized rectal refractory relapse renal response rheumatoid arthritis risk role salicylates side-effects steroid steroid-dependent steroid-refractory sulphasalazine tacrolimus Targan therapeutic therapy thiopurine methyltransferase TNF-a toxicity transactivation transcription transplantation treated treatment of Crohn's ulcerative colitis weeks