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Recent advances in understanding ulcerative colitis

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Abstract

Ulcerative colitis, one of the two main forms of inflammatory bowel disease, is characterized by inflammation of the large bowel with constant involvement of the rectum, and a possible continuous retrograde distribution up to the cecum. Typical macroscopic lesions are mucosal ulcerations, with immune cell infiltration and cryptic abscesses at histology. Ulcerative colitis usually manifests with bloody diarrhea, is associated with a number of extra-intestinal manifestations, and may be acutely complicated by toxic megacolon. Longstanding disease may predispose to the development of colorectal cancer. Therapeutic options include mesalazine, corticosteroids, immunomodulators and biologic agents; however, if these treatments fail, the only available therapeutic choice remaining is the surgical removal of the colon. This review emphasizes novel concepts in the basic aspects of ulcerative colitis, and, in addition to the current clinical and diagnostic knowledge, it also describes new treatment options for this condition.

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Abbreviations

5-ASA:

5-Aminosalicylic acid

DAI:

Disease activity index

IFN:

Interferon

IL:

Interleukin

pANCA:

Perinuclear anti-neutrophil cytoplasmic antibody

Th:

T helper cell type

TNF:

Tumor necrosis factor

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Authors and Affiliations

  1. First Department of Medicine, Centro per lo Studio e la Cura delle Malattie Infiammatorie Croniche Intestinali, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Piazzale Golgi 19, 27100, Pavia, Italy

    Antonio Di Sabatino, Paolo Biancheri, Laura Rovedatti & Gino Roberto Corazza

  2. Centre for Immunology and Infectious Disease, The Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK

    Thomas Thornton MacDonald

Authors
  1. Antonio Di Sabatino
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  2. Paolo Biancheri
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  3. Laura Rovedatti
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  4. Thomas Thornton MacDonald
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  5. Gino Roberto Corazza
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Corresponding author

Correspondence to Antonio Di Sabatino.

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Search strategy and selection criteria

We performed a comprehensive MEDLINE search by using the medical subject heading (MeSH) terms “ulcerative colitis” and “inflammatory bowel disease” for articles published between January 2000 and July 2011, but we did not exclude commonly referenced and highly regarded older publications. We also searched the reference lists of review articles on ulcerative colitis and inflammatory bowel disease for extra papers we judged relevant.

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Di Sabatino, A., Biancheri, P., Rovedatti, L. et al. Recent advances in understanding ulcerative colitis. Intern Emerg Med 7, 103–111 (2012). https://doi.org/10.1007/s11739-011-0719-z

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