The Role of TNF in Ulcerative Colitis

¹ Massachusetts General Hospital Crohn's and Colitis Center and Harvard University

^* To whom correspondence should be addressed. E-mail: bsands{at}partners.org.

	Abstract

Standard of care for ulcerative colitis involves long-term pharmacotherapy or colectomy. Approximately 20% to 30% of patients eventually require a colectomy because patients either do not respond or cannot tolerate the currently available pharmacotherapies. Advances in our knowledge of the pathophysiology of ulcerative colitis have highlighted the importance of cytokines such as tumor necrosis factor alpha (TNF) in the inflammatory process. TNF is a proinflammatory mediator that plays an integral role in the pathogenesis of inflammatory bowel disease. In addition, mounting evidence indicates a genetic association between TNF and ulcerative colitis. Furthermore, increased TNF levels have been demonstrated in studies of patients with ulcerative colitis. TNF is likely an important component in the pathophysiology of ulcerative colitis, and thus agents targeting TNF in ulcerative colitis have been studied. Recent randomized controlled trials have confirmed that biologic anti-TNF therapy is effective in ulcerative colitis. Soluble TNF receptors or biologic agents that suppress or inhibit TNF production may also show therapeutic promise.
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