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Ulcerative colitis: Fresh approaches to taming inflammation

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Ulcerative colitis is one of the most common forms of inflammatory bowel disease

and is characterised by inflammation of the colon and the rectum.

The walls of the colon — also known as the mucosa — become inflamed

and no longer provide an effective barrier between the inner cavity

and the surrounding connective tissue, allowing gut microbes to cross the epithelial layer.

This causes inflammation of the mucosa and leads to a raft of unpleasant symptoms

such as abdominal pain, diarrhea, fatigue and rectal bleeding.

There are several commonly used anti-inflammatory and immunosuppressive drugs,

but they come with side effects and aren't long-lasting for many patients.

Currently, 15% of people with ulcerative colitis will require surgery

to remove some or all of the colon within 20 years of diagnosis.

Luckily, new insights into the immunology of this condition

are helping scientists develop new effective treatments.

One new class of treatments is aimed at preventing the inflammation in the first place,

by bolstering the physical integrity of the colon's epithelium.

This keeps the immune-triggering bugs confined to the interior of the colon.

Some of these treatments work by exploiting a human protein called IL-22

which helps strengthen the epithelial layer.

One new drug in development targets the receptor for IL-22 on the epithelium itself,

activating it and thereby initiating healing of epithelial cells and the mucus layer.

This drug is currently in phase two trials.


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