Cyclosporine: Is There a Role in Inflammatory Bowel Disease?

Abstract

T HE IDIOPA Tl IIC IN FLAM MA TOR y BOWEL DISEASES (mn) are a spectrum of disorders characterized by chronic inflammation of the gastrointestinal tract. Genetic ( 1-5), enmonmental (6), dietary (7) and infectious agents (7 ,8-15) have been implicated in the cause of 180; however, much more evidence is required before any is considered proven.Because the exact etiology of IBO has thus far been difficult to establish many investigators consider that the basis of the disease lies in an endogenous immunolog1cal defect. Thtrty years ago Broberger and Pearlmann (16) first demonstrated chat IBO was associated with anti-epithelial cell antibodies in both blood and draining lymph nodes in patients with ulcerative colitis. Since then a large body of evidence has grown co support the immunologic hypothesis of IBO pathogenesis.Prior co examining the concept chat 180 is a consequence of an immunologic process it is important to review the function of the mucosa I immune system in normal i ndividuals. The gastrointestinal luminal environment contains numerous substances capable of activating rhe immune system. However, the face chat chis does not occur can be attributed co the mucosa! immune systems 'programmed' unCorrespondence: Dr Richard N Feclorak, Orn1ron of Gwcroentcrolo,n,