A Bench-to-Bedside Trail of Research Leading to the Understanding and Treatment of Ulcerative Colitis

The inflammatory bowel diseases (IBDs), Crohn’s disease and ulcerative colitis, are fairly common chronic inflammatory diseases of the gastrointestinal tract that are generally thought to be due to abnormal immune responses to specific antigens and innate ligands in the normal bacterial flora of the gastrointestinal tract. Inasmuch as such antigens have access to the internal milieu, they are immunologically equivalent to self antigens. On this basis the IBDs are properly considered autoimmune diseases. Research conducted over the last two decades in the Mucosal Immunity Section (MIS) of the Laboratory of Host Defenses of the NIAID has played a leading role in the unraveling of the causes of these diseases, as well as in the development of agents that can conceivably bring these diseases under control [1]. Such research has centered on the development and study of experimental models of mucosal inflammation, as well as the underlying and basic immunologic processes that underlie such inflammation [2]. In addition, they have involved studies of patients with IBD, including studies that probe steady-state immunologic responses in patients with ongoing inflammation, as well as studies that gauge patient responses to various forms of therapy. In the following review of the work of the Mucosal Immunity section we will begin with a short discussion of our work addressing the basic immunology and treatment of Crohn’s disease. We will then move to our main focus, our ground-breaking and unique studies of ulcerative colitis.