The Future

The cause of UC is still unknown. However, the concept that it may be provoked by changes in the bacteria in the intestine, which trigger off a cascade of events leading first to inflammation in the lining of the gut wall and then to inflammation in more distant tissues appears to remain valid.

This means that there is considerable potential for new research and treatment. Future work will focus on manipulation of bacteria in the bowel and the dissection of the immune response in order to provide agents, which block its development.

Already monoclonal antibodies exist against TNF-a and a-integrins. Drugs are being developed against NF- B, which initiates much of the inflammatory process. Others such as CDP-571, Etanercept, Thalidomide, Tacrolimus and Mycophenolate mofetil are being evaluated; new compounds continue to emerge.

The outlook is extremely encouraging.