Lancet review: Inflammatory Bowel Disease

Lancet review: Inflammatory Bowel Disease

Two articles in the Lancet provide a review on inflammatory bowel disease (IBD; Crohn's disease and ulcerative colitis).

The first article looks at the cause and immunology behind IBD and includes a discussion around how environmental factors (e.g. cigarette smoking, sanitation), infectious microbes, ethnic origin, genetic susceptibility, and a dysregulated immune system can lead to mucosal inflammation.

The authors of the second article critically review the evidence for established treatments (5-aminosalicylic acid compounds, corticosteroids, immunomodulators, calcineurin inhibitors) and emerging new therapies - including biological therapies directed at cytokines (e.g., infliximab, adalimumab, certolizumab pegol) and receptors involved in T-cell activation (e.g., visilizumab, abatacept), amongst other agents (such as natalizumab, MLN-02, alicaforsen, interleukin 10, antibiotics, prebiotics, probiotics). The second article is set out under the following headings:

• Ulcerative colitis
• Crohn's disease
• Extraintestinal manifestations of inflammatory bowel disease
• Emerging therapies for inflammatory bowel disease
• Safety and monitoring of medical treatments for inflammatory bowel disease
• Neoplastic complications of inflammatory bowel disease

Cause and immunobiology review: Lancet 2007; 369: 1627-40; clinical aspects and treatment: Lancet 2007; 369: 1641-57 (links to abstracts).