Ulcerative colitis

Ulcerative colitis is a lifelong inflammatory disease affecting the rectum and colon to a variable extent. In 2023, the prevalence of ulcerative colitis was estimated to be 5 million cases around the world, and the incidence is increasing worldwide. Ulcerative colitis is thought to occur in people w...

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Podrobná bibliografia
Vydané v:	The Lancet (British edition) Ročník 402; číslo 10401; s. 571 - 584
Hlavní autori:	Le Berre, Catherine, Honap, Sailish, Peyrin-Biroulet, Laurent
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	England Elsevier Ltd 12.08.2023 Elsevier Limited
Predmet:	Adrenal Cortex Hormones - therapeutic use Biomarkers Colitis, Ulcerative - diagnosis Colitis, Ulcerative - epidemiology Colitis, Ulcerative - therapy Corticoids Corticosteroids Crohn's disease Cytokines Diarrhea Disease prevention Drugs Epidemiology Fecal incontinence Humans Immune response Immunosuppressive agents Industrialized nations Infections Inflammation Inflammatory bowel disease Inflammatory bowel diseases Integrins Janus kinase Kinases Mesalamine - therapeutic use Modulators Pathogenesis Pathophysiology Patients Permeability Precision medicine Remission Remission (Medicine) Sphingosine 1-phosphate Tumor necrosis factor-TNF Ulcerative colitis
ISSN:	0140-6736, 1474-547X, 1474-547X
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Popis
Shrnutí:	Ulcerative colitis is a lifelong inflammatory disease affecting the rectum and colon to a variable extent. In 2023, the prevalence of ulcerative colitis was estimated to be 5 million cases around the world, and the incidence is increasing worldwide. Ulcerative colitis is thought to occur in people with a genetic predisposition following environmental exposures; gut epithelial barrier defects, the microbiota, and a dysregulated immune response are strongly implicated. Patients usually present with bloody diarrhoea, and the diagnosis is based on a combination of clinical, biological, endoscopic, and histological findings. The aim of medical management is, first, to induce a rapid clinical response and normalise biomarkers and, second, to maintain clinical remission and reach endoscopic normalisation to prevent long-term disability. Treatments for inducing remission include 5-aminosalicylic acid drugs and corticosteroids. Maintenance treatments include 5-aminosalicylic acid drugs, thiopurines, biologics (eg, anti-cytokines and anti-integrins), and small molecules (Janus kinase inhibitors and sphingosine-1-phosphate receptor modulators). Although the therapeutic options are expanding, 10–20% of patients still require proctocolectomy for medically refractory disease. The keys to breaking through this therapeutic ceiling might be the combination of therapeutics with precision and personalised medicine.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23
ISSN:	0140-6736 1474-547X 1474-547X
DOI:	10.1016/S0140-6736(23)00966-2