Biological Therapy For Inflammatory Bowel Disease - Rationale For Biological Therapy

Rationale For Biological Therapy

Prior to the development of biological therapy as a modality to treat IBD, other medications that modulate the immune system—including 5-aminosalicylates, steroids, azathioprine, and other immunosuppressants—were primarily used in treatment. Patients with Crohn's disease that developed complications, including fistulae (= abnormal connections to the bowel) were treated with surgery. Patients with ulcerative colitis who do not respond to medications are still treated with colectomy (= removal of the colon).

However, basic science research showed that there were many cytokines that were elevated in both Crohn's disease and ulcerative colitis. Crohn's disease cytokines, are of the type 1 (Th1) cytokines which include TNF-α, interleukin-2, and interferon γ. Ulcerative colitis was less conclusively linked to the production of Th2 cytokines.