Anti-TNF antibody treatment of Crohn's disease.

Crohn’s disease and ulcerative colitis are the two idiopathic chronic inflammatory bowel diseases. Although these diseases may show substantial phenotypic overlap, it is widely accepted that these represent distinct pathogenic entities. The cause of neither ulcerative colitis nor Crohn’s disease is known, and genetic as well as environmental factors have been implicated. Previous reports implicating single microbial pathogens (Mycobacterium paratuberculosis, measles) in Crohn’s disease are controversial and have not been confirmed. On the other hand, evidence that antigen driven ill controlled activation of mucosal T lymphocytes is a major disease mechanism has accumulated in recent years, and this has led to novel therapeutic strategies. I here review the clinical results of anti-TNF antibody treatment against the background of current knowledge of the regulation of mucosal immune activation.