T cell receptortc T BIL MHC class CD4 CD8 TIgAIgG IL-2 T IL-2 mna IL-2 CD4 IL-2 mna IL-10Th2CD4 T LPSIFN- /M IL-1, IL-6, TNF- IL-10TNF- IL-10 MH
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1 , 2000 IBD IBD IBD 21 IBD IBD Inflammatory Bowel Disease: IBD IBD1 /M /M ,000 16,000 E. coli Enterobacterial Common AntigenECA Bacteroides vulgatus carageenan IL-2IL-10
2 T cell receptortc T BIL MHC class CD4 CD8 TIgAIgG IL-2 T IL-2 mna IL-2 CD4 IL-2 mna IL-10Th2CD4 T LPSIFN- /M IL-1, IL-6, TNF- IL-10TNF- IL-10 MHC class IL-10 IL-7 HLA-B27 IgA NO n-3/n-6 5-lipoxygenase COX TNF- NOS
3 ECA Shorter G MHC class HLA-DIBD HLA-D HLA-D HLA-D IBD HLA-D HLA-D C3Factor BIL-1IL-8IL-10 TNF- in vitro IL-1 IL-8 cross talk 1 HLATTC T HLA HLA A2 A10Bw35Bw40 A9B5D2Bw52- D2 D2 7080DB1*1502 DB1*1501
4 DB1*1502Bw52 D2 DB1*1502 DB1* B51Bw61D4 Dw53 16 Wegener IgGantineutrophil cytoplasmic antibodiesanca ANCA HLA classd2anca D
5 male female male female ab1,c,, a b1 i ii 2 Xi ii iii c bc
6 3 5- lipoxygenasecycloxygenase B ASA g/day 1.5 g/day 3040 mg/day mg/kg B.W./day mg/day210 mg2 5 mg mg/day6-mp 3050 mg/day 5-lipoxygenase B4 7
7 / 5 Hb10g/dl 6 30mm/h Hb10g/dl A2 SASP5-ASA SASP prostaglandin G2 5 HPETE prostaglandin H2 leukotriene A4 SASP SASP PGE2 PGI2 TXA2 LTC4D4 LTB4 PGProstaglandinLTleukotrieneTXthromboxaneSASPsalicylazosulfapyridine 5-ASA5-aminosalicylic acid5hpete5-hydroperoxyeicosatetraenoic acid
8 g/ 34.5g/ 12mg/ 12g/ g/ 34.5g/ ml/ 12mg/ 12g/ ml/ 1.5g/ 2g/ mg/ 11.5mg/kg ACTH 4050/ g/ 34.5g/ ml/ 3040mg/ 6MP 50100mg/ 1.52mg/kg 20mg/ 25mg 40mg/ 230mg 20mg mg 11.5mg/kg4 ACTH mg 3
9 1 Lymphocytapheresis Granulocyte-monocytapheresis Leukocytapheresis: LCAP 1995Sawada LCAP 40 LCAP70 LCAP 70 LCAP20 LCAP4 TIL-2IFN- T 7 204mg/kg/ ,00015,000mg TPNPSL 50mg iv TPNPSL 60mg iv PSL 20mg po TPNPSL 40mg iv TPNPSL 40mg iv TPNPSL 40mg iv TPNPSL 40mg iv TPNPSL 40mg iv TPNPSL 15mg po TPNPSL 40mg iv TPNPSL 60mg iv TPNPSL 50mg iv
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12 azoreductase 5-ASA 8 65-ASA mg/day g/day mg/day6-mp3050 mg/day g/day g/day mg/day mg/day 7501,000 mg/day 750 1,000mg/day TNF-IL-10 Van Dullemen TNF- 16 CD4TCD4 17 IL g/kg mg 50100mg 4050mg 1,200kcal 3g 1.53g and or 1,200kcal
13 NF-KBIL-1TNF- NF-KB B4A stricture-plasty Seton N-5 ASA N-5 ASA SASP , ,
14 9Crohn , Crohnamino acid based diet oligopeptide based diet randomized controlled trial , steatocrit , JJPEN Belluzzi A, Brigonola C, Campieri M et al: Effect of an enteric-coated fish-oil preparation on relapses in Crohns disease. N Engl J Med 334: , Van Dullemen HM, Van Deventer SJ, Hommes DW et al : Treatment of Crohns disease with anti-tumor necrosis factor chimeric monoclonal antibodyca2. Gastroenterology 109: , Deusch K, Mauthe B, eiter C: CD4-antibody treatment of inflammatory bowel disease : One year follow up. Gastroenterology 104: 691A, Lerebours E, Bussel A, Modigliani et al: Treatment of Crohns disease by lymphocyte apheresis: A randomized controlled trial. Gastroenterology 107: , Inflammatory Bowel Diseaseecent Trends Tadao Bamba Second Department of Internal Medicine, Shiga University of Medical Science Basic and clinical studies on the etiology and pathophysiology of inflammatory bowel disease (IBD) have progressed remarkably in the past several years. Based on the results of these studies, new therapies have been developed from the viewpoint of molecular biology, and are applied clinically. On the other hand, part of the etiology of IBD will be clarified by way of clinical epidemiological analyses of factors that are causing increases in the number of patients with IBD, and because of the fact that an elemental diet can cure such lesions. Investigations of specific genes of IBD and studies on pathogenesis of IBD from viewpoints of intraluminal bacterial flora and food antigens are anticipated in the 21st century. IBD develops as a result of a complicated interrelation of many factors such as the intraluminal environment, intestinal epithelial cells, submucosal infiltration of inflammatory cells and immunological response. Therefore, the therapy of IBD should be performed taking each factor into consideration. : Ulcerative colitis, Crohns disease, Inflammatory bowel disease
The Indirect Support to Faculty Advisers of die Individual Learning Support System for Underachieving Student The Indirect Support to Faculty Advisers of the Individual Learning Support System for Underachieving
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