Quantitative Pharmacology and Individualized Therapy Strategies in Development of Therapeutic Proteins for Immune-Mediated Inflammatory Diseases
by Honghui Zhou, Diane R. Mould
2 The Role of Biomarkers in Treatment Algorithms for Ulcerative Colitis (UC)
Reena Khanna1 and Brian G. Feagan2
1University of Western Ontario, Department of Medicine, Division of Gastroenterology, London, Ontario, Canada
2University of Western Ontario, Department of Epidemiology and Biostatistics, London, Ontario, Canada
2.1 Background
Ulcerative colitis (UC) is a chronic inflammatory condition of the gastrointestinal tract resulting from pathologic immune responses to luminal antigens [1]. The disease typically presents in early adult life with bloody diarrhea as the most common clinical manifestation. The global incidence of UC has increased markedly in the past few decades with the greatest rates observed in Western industrialized countries. However, the incidence rates have also started to rise in India, Asia‐Pacific, and the Middle East. The management of UC is primarily medical, however, if drug therapy fails, colectomy may become necessary [2]. In patients who require surgery, restorative proctocolectomy and ileal pouch‐anal anastomosis (IPAA) is the gold‐standard surgical procedure whereby the small bowel is translocated to the pelvis to create a continent reservoir, a pouch, after colectomy. IPAA maintains continuity of the gastrointestinal tract and improves patients' health‐related quality of life. However, complications of this procedure include pouchitis, cuffitis, involvement with Crohn's disease (CD), and infertility [3].
The high rates of surgery that ...