[Immunology in medical practice. IV. Inflammatory bowel diseases: pathogenic starting points for specific therapy].
The cause of inflammatory bowel diseases is unknown, but T-cells play an important part in the pathogenesis of Crohn's disease. It was shown in recent years that activated T-cells produce certain cytokines that cause inflammation (interferon-alpha, tumour necrosis factor-alpha or TNF-alpha), but also cytokines (interleukin-10 or IL-10, transforming growth factor-alpha) which on the contrary inhibit inflammation. On the basis of this knowledge, the mucosal inflammatory reaction can be counteracted in a rational manner: antibodies against TNF-alpha in most patients with Crohn's disease who failed to respond to corticosteroids led to substantial reduction of disease activity. The first experiences with IL-10 treatment of Chrohn patients are also encouraging. It is expected that in the near future still more forms of immunotherapy directed against cytokines will become available.
van Deventer
S J
SJ
Academisch Medisch Centrum, Laboratorium voor Experimentele Interne Geneeskunde, Amsterdam.
D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D003093:Colitis, Ulcerative / Q000276:immunology; D003424:Crohn Disease / Q000276:immunology; D016207:Cytokines / Q000276:immunology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000276:immunology*; D007378:Interleukins / Q000235:genetics / Q000276:immunology; D051379:Mice; D018345:Mice, Knockout; D016513:Mice, SCID; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology
D000911:Antibodies, Monoclonal; D016207:Cytokines; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha