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This work has broad applications in clinical medicine, ranging from prevention and treatment of organ and bone marrow transplant rejection, management of various autoimmune disorders (for example, rheumatoid arthritis), skin disease and asthma. Whereas traditionally only a small repertoire of immunosuppressive agents was available for clinical use, recent discoveries have significantly increased the number of approved agents, resulting in numerous trials to further evaluate their potential. There is also considerable interest in the potential of cell-based therapies (particularly hematopoietic stem and dendritic cell therapy) of allo- and autoimmunity. Important recent advances in the immunotherapy of allergic diseases are also covered in this book. This volume is intended both for practising physicians and surgeons and for biomedical scientists at the graduate/postdoctoral levels, and is designed to provide the theory behind these various approaches to immunosuppression, and to provide state-of-the-art reviews of current developments in each area.
In recent years considerable progress has been achieved in regard to our understanding of the induction and modulation of the immune response in the intestinal mucosa. It is clear that this mucosal immune reaction is predominantly steered by certain T-cell populations, which are characterized by their cytokine secretion profile. Less well known are the conditions under which the uptake and processing of a specific antigen leads to a certain immune response, whether it be protective, tolerant or inflammatory. However, here again distinct progress has been made in our understanding. Equally significant for immune regulation in the gut appears to be so-called innate immunity. Every shift of equilibrium in the highly regulated mucosal immune reaction is accompanied by an inflammatory reaction and destruction of the mucosa. In nearly all cases, this inflammatory response is dependent on the presence of bacterial intestinal flora. This book, the proceedings of Falk Symposium 133 on Mechanisms of Intestinal Inflammation: Implications for Therapeutic Intervention in IBD', held in Berlin, Germany, on 10-11 June 2003, summarizes present knowledge in the area of unspecific and specific immune reactions in the gut, recording the gaps in our knowledge and, in particular, presenting the possibilities of targeted intervention. The link to inflammatory bowel diseases - Crohn's disease and ulcerative colitis - is always in focus. Chapters by an international panel of basic scientists, clinical researchers and clinicians also record the problems which can originate through today's possible modulation of the immune reaction, setting the basis for review of clinical problems. This book is valuable readings for all scientists and physicians, who, from different perspectives, have an interest in research on IBD and in the clinical management of these diseases.
This book conjoins the latest advances on the use of endoscopy to diagnose, monitor, and treat patients with inflammatory bowel disease. Chapters include the historical use of rigid sigmoidoscopy, non-interventional imaging procedures, and the correlation of pathology and endoscopic visualization. This is the first book to include individual chapters in gastroenterology, colorectal surgery, and IBD texts, the preeminent role of endoscopic imaging in the management of chronic ulcerative colitis, and Crohn's disease. It also includes chapters on capsule endoscopy and balloon and overtube-assisted enteroscopy to define the presence and activity of Crohn's enteritis and additional chapters defining the use of random biopsies versus chromoendoscopy, and computer enhanced imaging to define possible dysplasia development. The book also includes access to online videos, making it the ultimate verbal and visual tool for all medical professionals interested in the advances in the field over the last several decades. Endoscopy in Inflammatory Bowel Disease is a concise text that is of great value to practicing endoscopists, gastroenterologists, general or colorectal surgeons, physicians in training, and all medical professionals caring for patients with inflammatory bowel disease.
Pediatric Inflammatory Bowel Disease, Second Edition provides an essential reference with an emphasis on the unique pediatric issues of IBD. Chapters focus on complications of IBD specific to children and adolescents. Treatment recommendations are based on the latest clinical research available. The textbook also presents sections dedicated to the aspects of participation in clinical research unique to children and adolescents and the complicated yet vital process of successfully transitioning a patient from a pediatric to adult specialist. Controversies in pediatric IBD care such as the off-label use of medications are also covered. The format incorporates multiple tables, graphs, and figures to improve readability and make for an efficient reference for clinicians to use. Thoroughly revised and updated from the first edition, the volumes includes new therapies that are currently being used or tested for treatment of IBD, important areas regarding incidence and prevalence, immunization and response to vaccine administration as well as advancements in our understanding of growth and development with particular to the use of growth hormone therapy. Other new areas covered include important topics of complementary and alternative medicine use in IBD, immunization, and liver disease in IBD. Pediatric Inflammatory Bowel Disease, Second Edition is a valuable resource for pediatric gastroenterologists as well as adult gastroenterologists.
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 new edition is a unique combined resource for physicians and scientists addressing the needs of both groups. In addition to stimulating exchange and collaboration and shortening the path between discovery and application of new knowledge, the book helps clinicians understand new therapeutic concepts from their origins. The volume serves as a comprehensive guide to the current diagnostic modalities, including enhanced imaging techniques such as MRI and CT enterography, virtual colonoscopy, ultrasound, and endomicroscopy, as well as conventional and complex immunomodulatory principles. The latest edition also includes revised chapters from the previous edition, as well as new chapters reflecting current developments in the field. Written by experts in their field, Crohn’s Disease and Ulcerative Colitis: From Epidemiology and Immunobiology to a Rational Diagnostic and Therapeutic Approach, Second Edition is of great value to gastroenterologists, surgeons, internists, pediatricians and gynecologists trainees, as well as all those involved in Crohn’s disease, ulcerative colitis, and related autoimmune disorders.
Atlas of Endoscopy Imaging in Inflammatory Bowel Disease is a complete reference providing all aspects of endoscopy imaging in inflammatory bowel disease (IBD). Building on the etiology and pathogenesis of IBD and taking into account the wide range of clinical presentations and phenotypes that reflect a long list of endoscopic features, this book systematically and exclusively presents all IBD-related endoscopy imaging for optimal understanding, diagnosis and management. - Provides systemic classification and characterization of endoscopy imaging in the surgically altered bowel and in healthy and diseased IBD patients - Incorporates state-of-the-art research in the area of endoscopy imaging in CD and UC, from current literature and the vast experience of a panel of national and international experts - Covers all possible aspects related to endoscopic imaging in Inflammatory bowel disease
"Prior to the development of the first fibre-optic endoscopes in the 1960's, gastroenterology, in common with other traditional medical specialties, relied on biochemical and radiological techniques in order to investigate the gastrointestinal tract. Histological confirmation of a disease process usually required the presence of a surgeon, was invasive, and carried inherent risks. Because of a rapid improvement in technology, we are now able to sample the entire gastrointestinal tract from the mouth and anus through to the ileal / jejunal junction"--
Ulcerative colitis and Crohn's disease remain a great therapeutic challenge to the medical community. In recent years knowledge about the pathogenesis of these diseases has progressed rapidly but the cause of the diseases remains completely unknown. It has become clear that dysregulation of the mucosal immune system is the basis for the chronic evolution of the diseases in a genetically susceptible population. Exciting new therapeutic approaches have been attempted in the last couple of years and cytokine and anti-cytokine treatments in particular seem very promising, especially in intractable disease. The format of the Falk Symposium 106 on `Advances in Inflammatory Bowel Diseases', held in Brussels, Belgium, June 18-20, 1998, was somewhat innovative as each session attempted to link the new insights into pathogenetic mechanisms with new therapeutic approaches, resulting in optimal information transfer. The classic therapeutic schemes were updated with a special focus on step-wise build-up of therapy.