Inflammatory bowel disease--a radical view.

Abstract

Although the aetiology of inflammatory bowel disease remains unknown, its pathogenesis is gradually being unravelled. Increasing attention has been focused recently on the role of free radicals, in both normal metabolism and defence against disease, and also in a wide variety of conditions, for example rheumatoid arthritis, diabetes mellitus, atherosclerosis, pancreatitis, and peptic ulcer, in which oxidant stress seems to exceed homeostatic mecha- nisms. Free radical activity may contribute to the patho- genesis of both inflammation and cancer. This review examines the evidence that abnormal oxidative metabolism is of central importance to active inflammatory bowel disease. The potential pathogenicity of free radicals has been empha- sised by recent work which suggests that reactive oxygen metabolites are not just one of a number of mediators and cytokines involved in the inflammatory process in inflam- matory bowel disease but many have a pivotal role by initiating the expression of genes controlling may other aspects of the inflammatory, immune, and acute phase response, by activation of the transcription factor NF-x,.5