Current Drug Targets - Volume 13, Issue 10, 2012

Over the past few years, the technical evolution of ultrasound equipment, the use of oral and intravenous contrast agents, and an increase in the expertise of sonographers has enhanced the role of ultrasonography that plays in the assessment of the gastrointestinal tract. In chronic inflammatory conditions, primarily CD, this technology can be used not only for diagnostic purposes, but it has also been suggested that Read More

There is growing evidence of the importance of mucosal healing (MH) in ulcerative colitis, but whether or not it should be a future primary treatment goal is still under intense discussion. Within the last decade many clinical trials have focused not only on response and remission rates but also on achievement of MH, while in clinical practice we still make treatment decisions on the basis of clinical symptoms. There is so Read More

Inflammatory bowel disease diagnostic and management algorithms continue to rapidly evolve. This is partly driven by advanced radiologic techniques that provide objective, non-invasive evaluations. The realms of information provided by radiology and endoscopy continue to be intertwined. This has led to the question of whether radiologic applications will continue to expand, and eventually replace endoscopy in Read More

The clinical management of Crohn's disease (CD) has evolved in recent years from symptom control to healing of mucosal lesions. Mucosal healing, induced and maintained by immunomodulators and/or biologicals, has been shown to alter the disease course in patients with CD. As a consequence, long-term disease outcomes have been dramatically improved, in particular since the introduction of anti-tumor necrosis Read More

Endoscopy is currently considered the reference standard for the evaluation of disease activity and severity in patients with inflammatory bowel disease (IBD). However, information provided by endoscopy is limited to the mucosal surface and cannot always be complete. Cross-sectional imaging techniques are gaining acceptance for the assessment of patients with Crohn's disease (CD) and ulcerative colitis (UC). Overall Read More

Capsule endoscopy (CE) represents a significant advance in the investigation of small bowel diseases. Twothirds of Crohn's disease (CD) patients have small bowel involvement at diagnosis. Study of small intestine mucosa by CE may have a strong impact on CD management in a near future. CE may be superior to small bowel cross-sectional imaging for detection of mucosal lesions consistent with CD and a normal CE has a hi Read More

The risk of developing colorectal cancer (CRC) is increased in patients with inflammatory bowel disease (IBD), particularly if the disease is extensive and its duration long-standing. Endoscopic guidelines have been developed with the goal of detecting early neoplastic changes prior to development of advanced malignancy. The current surveillance strategy of surveillance colonoscopy, with multiple random biopsies, mo Read More

One of the main challenges for clinicians dealing with Crohn's disease (CD) is to distinguish between inflammation and fibrosis, two sequential steps in the evolution of the intestinal disease. While inflammation is amenable to medical treatment, stricturing disease can only benefit from surgery. Magnetic resonance imaging (MRI) is a widely used tool in the diagnosis and assessment of CD. Recent data suggest that this technique Read More

Double balloon enteroscopy has been available since 2004 and is slowly emerging as a valuable procedure that has the potential to reach all parts of the small intestine, allowing biopsy and therapeutic intervention. This paper describes the background to its development, the mechanics of the procedure and the current and potential roles it has in relation to small bowel Crohn's disease.

Anorectal involvement in Crohn's disease (CD) causes perianal lesions that vary from simple asymptomatic skin tags, to complex disabling fistulas and abscesses. Perianal CD affects approximately one-third of patients; its management is challenging and may require combined medical and surgical treatment, which has proven to offer the best chance of success. An optimal preoperative disease assessment is crucial in orde Read More

In ulcerative colitis, mucosal healing has clearly been incorporated in the assessment of treatment efficacy. In Crohn's disease, this concept has only emerged in recent clinical trials with biological therapies. Systemic steroids don't reliably induce mucosal healing in Crohn's disease, but purine analogues and anti-TNF agents have a potential to heal mucosal ulcerations. Evidence for mucosal healing has now been provided for th Read More

Crohn's disease leads to complications in the majority of patients on the long term. Strictures, fistulas and abscesses usually involve the bowel wall or extra-intestinal compartments, and conventional diagnostic tools, such as colonoscopy or barium studies, are not able to assess them. Magnetic resonance imaging has been proven to be accurate in detecting activity, severity and complications of Crohn's disease. Because of its re Read More

Most of the prostate cancers (PCa) in advanced stage will progress to castration-resistant prostate cancer (CRPC). Within CRPC group, 50-70% of the patients will develop bone metastasis in axial and other regions of the skeleton. Once PCa cells spread to the bone, currently, no treatment regimens are available to eradicate the metastasis, and cancer- related death becomes inevitable. In 2012, it is estimated that there will Read More

A hallmark of chronic kidney disease is hyperphosphatemia due to renal phosphate retention. Prolonged parathyroid gland exposure to hyperphosphatemia leads to secondary hyperparathyroidism characterized by hyperplasia of the glands and excessive secretion of parathyroid hormone (PTH), which causes renal osteodystrophy. PTH secretion from the parathyroid glands is controlled by the calcium-sensing rece Read More

Analysis of the crystal structure of beta-2 adrenoceptors (β2ARs) is providing new insights into the functioning of this receptor and perhaps of G-protein coupled receptors (GPCRs) as a whole. This class of receptors represents the target of at least a third of the drugs on the market and plays an essential role in the study of therapetic drug-response. Among GPCRs, the β2AR is the best understood in terms of function, expressi Read More