The Future of Ulcerative Colitis Treatment

An understanding of the medications and other treatments for ulcerative colitis requires intense research. In order to effectively fight UC, more must also be known about how the disease itself works. Current research is finally addressing this.

Probiotics is the study of naturally occurring helpful bacteria that regulate normal bacterial flora in the colon. Researchers suspect that ulcerative colitis may be exacerbated by imbalances in normal intestinal bacteria. Probiotics may be the answer for this problem. Ingestion of helpful bacteria may control imbalances of the normal bacteria. While recent research has deduced that ingestion is a beneficial route for treatment, issues such as correct dosage and length of treatment need more investigation.

An interesting case involved a leukemia patient who received a stem cell transplant while in complete remission. Just under four months following the transplant the patient developed antibiotic-resistant diarrhea, which proved to be the result of ulcerative colitis.

Another study evaluating the effect of bone marrow transplantation on five patients with Crohn's disease and leukemia found that four of the five had no indication of Crohn's disease in a follow up nine years after transplantation. While bone marrow transplantation for the treatment of UC has not been adequately studied, the results of this leukemia study suggest new approaches that should be considered in attempting to cure inflammatory bowel disease.

Although the results above are a bit mixed, both studies show that the cells of the immune system are involved in inflammatory bowel disease. Research will have to pinpoint the exact immunological pathways that promote and inhibit inflammation of the colon.

Some current research on inflammatory bowel disease involves the use of interleukin 2, a "biological response modifier" that can improve the immune system's reaction to disease conditions. It is being examined for its effects on mild to moderate ulcerative colitis.

Alicaforsen is a drug that inhibits the proteins thought to be responsible for inflammation in autoimmune conditions such as inflammatory bowel disease. Isis Pharmaceuticals in Carlsbad, California is currently in Phase II evaluation of an enema preparation of alicaforsen for treatment of UC. Initial results are promising.

Alizyme, a drug development company in Cambridge, UK, is currently in Phase III clinical trials for COLAL-PRED™. COLAL™ is a drug delivery system that includes a special coating that can be applied to drug pellets, tablets or capsules, which only breaks down by the bacterial enzymes in the colon. This means that oral medications for UC can be delivered directly to the large intestine rather than systemically, thereby minimizing or even eliminating some of the harmful side effects. The current Phase III trial is evaluating the efficacy of combining COLAL with the oral corticosteroid prednisolone.