Inflammatory bowel disease: Pandora's box, present and future.
Current treatment of inflammatory bowel disease is rather effective through it is only working in symptomatic fashion. Most recombinant "biologicals" have not been an overwhelming success. Infliximab has shown clinically relevant efficacy and is used in patients not responding to the standards. Alternatives such as modulating the bacterial-epithelial interaction, tightening of the mucosal barrier and maybe even immunostimulation should be studied since most recent finding on etiology and pathophysiology point to a disturbed barrier with consequent abnormal bacterial epithelial interaction as the main problem in the IBD syndrome. We still need to learn much but we should not focus only on immunosuppressive systems.
Schölmerich
Jürgen
J
Klinik und Poliklinik für Innere Medizin I, Klinikum der Universität Regensburg, D-93042 Regensburg, Germany. juergen.schoelmerich@klinik.uni-r.de
D000818:Animals; D001424:Bacterial Infections / Q000503:physiopathology; D004195:Disease Models, Animal; D006801:Humans; D007108:Immune Tolerance; D018928:Immunity, Mucosal; D015212:Inflammatory Bowel Diseases / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology* / Q000628:therapy; D019936:Probiotics