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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.
This book is the proceedings of the Falk Symposium No. 122 on
"Inflammatory Bowel Disease - A Clinical Case Approach to
Pathophysiology, Diagnosis, and Treatment," held in Bologna, Italy,
on June 22-23, 2001, and deals with some major issues concerning
Genetics of IBD, Pediatrics in IBD, Early vs Late IBD, Bacteria and
Gut Inflammation, Refractory CD, Fistulizing CD, Refractory Distal
Colitis, and Complications of Ileal-Pouch Anastomosis. The main aim
of the meeting was to highlight the value of an integrated clinical
approach and the importance of clinical research in developing
innovative methods of treatment.
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