Clinical Update on Inflammatory Disorders of the Gastrointestinal Tract

Description

Digestive-disease-associated mortality accounts for a major part of all deaths in Western societies and inflammatory diseases such as GI infections, viral hepatitis, GERD or cancers due to chronic inflammation have a tangible economic and social impact. What further aggravates the situation is the fact that complex immunological disorders have surfaced where anti-infective treatments are not effective. Fortunately, due to breakthroughs in basic research that are being successfully translated into clinical practice, new treatment strategies are constantly evolving. In addition to the development of new therapeutic measures, however, it is also mandatory to review and periodically refine established treatment regimens to reflect current knowledge and ensure up-to-date medical care.

Informations

• Publié par: S. Karger AG
• Date de parution: 12 novembre 2009
• Nombre de lectures: 1
• EAN13: 9783805592956
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Clinical Update on Inflammatory Disorders of the Gastrointestinal Tract
Frontiers of Gastrointestinal Research
Vol. 26
Series Editor
Markus M. Lerch   Greifswald
 
Clinical Update on Inflammatory Disorders of the Gastrointestinal Tract
Volume Editors
Julia Mayerle   Greifswald
Herbert Tilg   Hall in Tirol/Innsbruck
25 figures, 3 in color and 18 tables, 2010
Frontiers of Gastrointestinal Research
Founded 1975 by L. van der Reis, San Francisco, Calif.
_________________________
_________________________
Julia Mayerle Klinik für Innere Medizin A Klinikum der Ernst-Moritz-Arndt- Universität Greifswald Friedrich-Loeffler-Strasse 23A DE-17475 Greifswald
Herbert Tilg Bezirkskrankenhaus Hall in Tirol/ Innsbruck Christian Doppler Research Laboratory for Gut Inflammation Medical University Innsbruck Milser Strasse 10-12 AT-6060 Hall in Tirol/Innsbruck
Library of Congress Cataloging-in-Publication Data
Clinical update on inflammatory disorders of the gastrointestinal tract / volume editors, Julia Mayerle, Herbert Tilg.
p.; cm. –– (Frontiers of gastrointestinal research, ISSN 0302-0665 ; v. 26)
Includes bibliographical references and indexes.
ISBN 978-3-8055-9294-9 (hardcover: alk. paper)
1. Digestive organs––Pathophysiology. 2. Inflammatory bowel diseases. 3. Inflammation. I. Mayerle, Julia. II. Tilg, Herbert. III. Series: Frontiers of gastrointestinal research, v. 26. 0302-0665;
[DNLM: 1. Gastrointestinal Diseases. 2. Inflammation. W1 FR946E v.26 2010 / WI 140 C6408 2010]
RC802.9.C65 2010
616.3’44––dc22
2009036720
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents®.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2010 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel
ISSN 0302-0665
ISBN 978-3-8055-9294-9
eISBN 978-3-8055-9295-6
 
Contents
Preface
Mayerle, J. (Greifswald); Tilg, H. (Hall in Tirol/Innsbruck)
Hepatology
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Non-Alcoholic Fatty Liver Disease
Bugianesi, E. (Turin)
Fibrosis in the GI Tract: Pathophysiology, Diagnosis and Treatment Options
Pinzani, M. (Florence)
Chronic Hepatitis B: Pathophysiology, Diagnosis and Treatment Options
Wursthorn, K.; Mederacke, I.; Manns, M.P. (Hannover)
Chronic Hepatitis C: Pathophysiology, Diagnosis and Treatment Options
Asselah, T.; Soumelis, V.; Estrabaud, E.; Marcellin, P. (Paris)
Clinical Update on Inflammatory Disorders of the GI Tract: Liver Transplantation
de Rougemont, O.; Dutkowski, P.; Clavien, P.-A. (Zürich)
Hepatocellular Carcinoma
Peck-Radosavljevic, M. (Vienna)
Gastroenterology
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Coeliac Disease
Schuppan, D.; Junkler, Y. (Boston, Mass.)
Anti-TNF Therapy in Inflammatory Bowel Diseases
Fiorino, G. (Rome/Milan); Danese, S. (Milan); Peyrin-Biroulet, L. (Vandoeuvre-lès-Nancy)
Role of Epithelial Cells in Inflammatory Bowel Disease
Kaser, A. (Innsbruck)
GI Immune Response in Functional GI Disorders
Tack, J.; Kindt, S. (Leuven)
Probiotics in GI Diseases
Gionchetti, P.; Rizzello, F.; Tambasco, R.; Brugnera, R.; Straforini, G.; Nobile, S.; Liguori, G.; Spuri Fornarini, G.; Campieri, M. (Bologna)
Microscopic Colitis
Pardi, D.S. (Rochester, Minn.); Miehlke, S. (Dresden)
Pancreatic Disorders
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Inflammatory Proteins as Prognostic Markers in Acute Pancreatitis
Frossard, J.L. (Geneva); Bhatia, M. (Singapore)
Antibiotics, Probiotics and Enteral Nutrition: Means to Prevent Infected Necrosis in AP
van Doesburg, I.A.; Besselink, M.G.; Bakker, O.J.; van Santvoort, H.C.; Gooszen, H.G. (Utrecht); on behalf of the Dutch Pancreatitis Study Group
IKK/NF- κ B/Rel in Acute Pancreatitis and Pancreatic Cancer: Torments of Tantalus
Algül, H.; Schmid, R.M. (Munich)
Immunotherapy of Pancreatic Carcinoma: Recent Advances
Märten, A.; Büchler, M.W. (Heidelberg)
Gastric Disorders
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Helicobacter pylori Infection: To Eradicate or Not to Eradicate
Schütte, K.; Kandulski, A.; Selgrad, M.; Malfertheiner, P. (Magdeburg)
Carcinogenesis and Treatment of Gastric Cancer
Rad, R. (Cambridge); Ebert, M. (Munich)
Author Index
Subject Index
 
Preface
Disorders of the digestive tract and the liver impose a significant economic and health burden on society. The US National Institutes of Health have recently completed a survey according to which digestive diseases account for 35 outpatient visits and 5 hospital days per 100 residents annually. The direct cost for medical expenses amount to USD 100 billion for digestive disorders and the indirect cost to an additional USD 44 billion [ 1 ]. While the magnitude of these expenses is on a par with a good-sized modern-day economic stimulus package, the disorders also have a high social cost. Ten percent of all deaths are attributed to digestive disorders. The numbers in Europe are thought to correspond to those in the USA, and by far the largest proportion of patients are thought to be affected by inflammatory disorders of the liver, the pancreas and the GI tract.
The good news is that research into inflammatory digestive disorders is showing results, with new insights from research constantly being brought to the bedside, and a reduction in disease burden and mortality has been achieved for a number of disorders.
Inflammatory diseases of the GI tract no longer include only infectious disorders (for which long-established anti-infective treatments are available and constantly being improved), but also a number of complex immunological disorders which are currently attracting much scientific attention. In this rapidly developing field, where biologically relevant signalling pathways were identified only in recent years, therapies that are directly based on these research findings are becoming available. A prominent example is the TNF-α blockade used in inflammatory bowel disease. In the field of gastrointestinal inflammation the term ’from bench to bedside’ has become a reality.
This volume also covers emerging diseases such as microscopic colitis or nonalcoholic fatty liver disease that have only recently moved into the focus of scientific inquiry but which may have an unappreciated socio-economic impact.
Not all previously established treatment regimens have stood the test of time, and recent studies have questioned the evidence for using, for example, antibiotics, parenteral feeding or probiotics for patients with severe acute pancreatitis. Most pancreas experts were surprised to learn that the PROPATRIA trial on the use of probiotics in severe acute pancreatitis showed evidence for a harmful effect for a seemingly harmless therapy. The lesson from such negative studies is that controlled clinical trials should not only test novel treatment approaches but also challenge old assumptions about the standard of care.
The association between chronic inflammation and the development of cancer was recognized more than a century ago. As early as 1863 the German pathologist Rudolf Virchow reported the presence of leukocytes in neoplastic tissues and suggested a connection between inflammation and cancer. Nowadays clear associations have been shown between a variety of chronic inflammatory disorders such as Crohn’s disease, ulcerative colitis, pancreatitis, hepatitis or Helicobacter pylori-associated gastritis and an increased cancer risk of affected patients.
This volume of the Frontiers in Gastroenterology series includes up-to-date reviews on the relevant issues in inflammatory disorders of the GI tract, the liver and the pancreas. In a combination of expert basic research reviews and cutting-edge treatment guidelines the reader will learn about newly identified treatment targets and be able to participate in the development of novel treatment strategies. The fact that cancer