Inflammatory bowel diseases (IBD) are thought to be induced by a genetically impaired immune-response to normal antigens such as bacterial flora or foods. Medical treatment is unable to modify the natural course of these debilitating diseases. It supports physiological anti-inflammatory processes, trying to control intestinal inflammation and allow child's normal growth and development with the lowest toxicity. The possible different pathogenic mechanisms of IBD and their clinical heterogeneity make difficult to standardize therapeutic protocols. In ulcerative colitis therapy is modulated depending upon the clinical severity of the disease, in order to obtain and maintain clinical and endoscopic remission. In Crohn's disease the treatment must be tailored taking into account the different clinical subgroups, the involved sites and the compliance to the proposed therapies, primarily aiming to gain and maintain clinical remission. To the standard antinflammatory treatment such as salicilates and traditional steroids, drugs derived from the adult experience (immunosuppressants, new steroids, antibiotics, essential fatty acids) and nutritional therapy have been added to the pediatric armamentarium. Their rational use in the most convenient association seems to be the best way to reduce toxicity and the negative effects of the chronic intestinal inflammation on a developing organism. Recent advances in basic research have provided new insights into the role of immune cells and their cytokines in chronic intestinal inflammation. This has led to the development of treatments directed at altering specific pathogenic mechanisms that have the potential to modify the natural course of the disease. Monoclonal chimeric antibodies to the proinflammatory cytokine tumor necrosis factor α, recombinant cytokines and antinsense molecules have provided the most promising results.
|Translated title of the contribution||New therapeutical protocols of inflammatory bowel diseases (IBD)|
|Number of pages||11|
|Publication status||Published - 2000|
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health