Special Issue "Ulcerative Colitis: Current and Emerging Treatment Strategies"
A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepato-Pancreato-Biliary Medicine".
Deadline for manuscript submissions: 15 October 2019
Ulcerative colitis (UC) is one of the two forms of inflammatory bowel disease (IBD) with a high prevalence in Western countries, whose incidence is gradually increasing in newly industrialised countries in Africa, Asia, and South America. For many years salicylates, systemic and topical steroids and immunosuppressants were the cornerstones of UC drug therapy, without however significantly affecting the clinical course of the disease and, above all, without impacting its natural history.
Although its etiology is unknown, in the last 20 years considerable progress has been made in understanding its complex pathogenesis. In particular, the identification of specific cytokines (TNFa, integrins, etc) has allowed us to define specific therapeutic targets and the relative production of anti-TNFa monoclonal antibodies (infliximab, adalimumab, golimumab) and anti-integrins (vedolizumab) , currently available in Europe and North America.
However, although these therapies have allowed us to effectively treat a larger patient audience with "difficult" UC, such as steroid-dependent patients, steroid-refractoriness, and extraintestinal manifestations, there are still various unmet needs, such as failure or loss of response, and the increased risk, albeit mild, of infections or neoplasia, which require further pharmacological treatments that are possibly faster, more effective and safe. Thus, particular emphasis tends to be placed on some of the most recent biological therapies, which are proving promising in the treatment of IBD, with therapeutic target alternatives to the selective blocking of specific cytokines, such as interleukin 12/23 and SMAD7 inhibitors, and low molecular weight drugs (small molecule drugs (SMDs)), such as inhibitors of JAK kinases, sphingosine 1 phosphate (S1P) and phosphodiesterase 4. Furthermore, particular interest is also placed on cell-based therapies (stem cell transplantation).
Considering, therefore, the progressive enrichment of the therapeutic armament, this Special Issue, will consider the conventional therapy and the emerging treatments of UC in an attempt to place them in specific clinical contexts, in order to optimize their choice both in terms of effectiveness and safety.
Prof. Dr. Sandro Ardizzone
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- Ulcerative colitis
- Conventional therapy
- Emerging treatment
- Systemic and topical steroids
- Monoclonal anti-TNFa antibodies
- Monoclonal anti-integrine antibodies
- Small molecules
- Cell-based therapies