Published online May 6, 2015. doi: 10.4292/wjgpt.v6.i2.10
Peer-review started: January 18, 2015
First decision: February 7, 2015
Revised: March 2, 2015
Accepted: April 1, 2015
Article in press: April 7, 2015
Published online: May 6, 2015
Processing time: 102 Days and 22.1 Hours
Despite the level of sophistication they have reached nowadays, the available tools for treatment of inflammatory bowel disease (IBD) can at best chronicize the disease but not cure it. Chances to make leap forward from this hold-back may include designs to reach personalized treatment strategies taking advantage of modern genome associated studies, and shift resources towards unfolding inciting pathogenetic steps rather than continuing to develop drugs that address down-stream phenomena. We have arbitrarily chosen to scrutinize a few projects that may make their way in 2015 and mark the history of IBD research. The list includes: the role of appendix as a regulating factor in pathogenesis of ulcerative colitis/proctitis; the reappraisal of (auto)immune phenomena in the era of microbiome; projects to treat IBD by stem cell infusion; recognition of the crucial pathogenetic role of gut microbiome, and attempts to modify it to treat enteric diseases, from clostridium difficile infection to IBD.
Core tip: The inflammatory diseases of the gut (inflammatory bowel disease) continue to both constitute a medical challenge, and a formidable intellectual stimulus. The latter statement is based on the accumulating evidence that the IBDS are indeed syndromes whereby a few poorly penetrating polymorphic genes can affect at once the inflammatory balance in the barrier systems of the gut, the skin, and the airways. The former statement reflects the very fact that, though described in the 19th century, IBD continues to defeat our struggle to cure it, invading yet the hitherto unaffected landscapes of the Eastern World, almost as it was a response to our efforts. We deem that the address of the initiating factors, rather than the downstream phenomena, may be a strategy to wriggle out of the hold-up. The description of interventions such as appendectomy or microbiome replacement, among other options, witnesses our own way to interpret this need in the present editorial.