Posted 4/19/2008 5:33 PM (GMT -6)
I've long found this an interesting way of thinking about UC. After all, there is some genetic susceptibility, an initial trigger, and a vast lot of possible environmental or developmental factors. How do all of these interact to produce the symptoms to which we refer as ulcerative colitis? How much does the organic pathology of UC differ between individual sufferers? Calling it a "syndrome" like Judilyn or a even a spectrum (in the same sense as "autistic spectrum disorder") rather than a specific disease might be more accurate. I strongly suspect that improvements in treatment will come not from new wonder drugs which are great for everyone, but from improved diagnostics which provide a more specific description of what an individual is experiencing (type XXIII ulcerative colitis, maybe!) - and who then can be treated by very specific agents (agents which may only work for a very small proportion of UD patients, but give this small proportion significant relief). Unfortunately this is both a form of medicine with a small target population - hence not well funded by drug company research - and expensive. Still, there does seem to be recent progress in identifying some of the biochemistry of UC, so I expect we'll start seeing more drugs like Remicade, though perhaps which will only be used after genetic or other testing to determine if the patient is in the correct target group, in the not-too-distant future.

Craig

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