| [ Summary ] |
The occurrence of ulcerative colitis(UC) and the process of inflammation involve an autoimmune mechanism, abnormalities of crypt epithelial cells (accelerated apoptosis, etc.), invasion of inflammatory cells into the mucosa, and abnormal activation of these cells. Corticosteroids are considered, theoretically, to produce therapeutic responses in cases with such pathogenesis and pathophysiology. Corticosteroids are generally used in compliance with the guidelines provided by the Research Committee of Inflammatory Bowel Disease of the Ministry of Health and Welfare of Japan. In order to induce a long-term controllable state after remission, the policy is to begin treatment with a high dose of corticosteroids irrespective of disease activity with appropriate timing, while placing emphasis on initial treatment after the onset. Furthermore, after the initial remission, immunosuppressants such as azathioprine and tranilast or antioxidants may be used in addition. For refractory UC, the concurrent use of azathioprine, heparin and ulinastatin, as well as leukocyte apheresis and pulsed steroid therapy may be attempted aiming to avoid the use of steroids. |