Recent advances in the medical therapy of Crohn's disease in childhood.
Crohn's disease (CrD) is characterised by an ongoing inflammatory response in the gut, in the absence of an obvious trigger. The treatment of CrD in children, during relapse and remission, requires special consideration of growth and development. This review addresses the use of present medical management strategies, including enteral nutrition, corticosteroids, immunosuppression and anti-TNF-alpha therapies. Anti-inflammatory IL-11 and leukocyte adhesion inhibitors have shown only moderate clinical efficacy in adults. Emerging treatments directed against the inflammatory cascade under investigation include inhibitors of IL-6 and -12, IFN-gamma and MAPKs. Probiotics and colony stimulating factors aim to stimulate the innate immune system. Research data from clinical trials are reviewed and summarised in respect of their potential within paediatric practice.
Bremner
A R
AR
Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ.
Beattie
R M
RM
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002648:Child; D003424:Crohn Disease / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D004750:Enteral Nutrition / Q000639:trends; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000378:metabolism
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha