ROLE OF CYTOKINES AND PLATELET-ACTIVATING-FACTOR IN INFLAMMATORY BOWEL-DISEASE IMPLICATIONS FOR THERAPY

BACKGROUND: Platelet-activating factor (PAF) and cytokines, such as in terleukins, tumor necrosis factor, and others, are thought to play a r ole in the inflammatory process involving gastrointestinal disorders s uch as Crohn's disease, ulcerative colitis, ischemic colitis, or antib iotic-associated colitis. PURPOSE: This study was undertaken to review the latest literature on the role of PAF and cytokines in the genesis of inflammatory bowel disease and implications for therapy and manage ment. RESULTS: PAF is an endogenous phospholipid involved in hypersens itivity and inflammatory reactions such as platelet and neutrophil agg regation, vasodilation, increased vascular permeability, and leukocyte adhesion, which have been associated with inflammatory processes. Cyt okines are peptides that regulate and coordinate inflammatory and immu nologic responses. Increased production of cytokines has been reported during Crohn's disease and ulcerative colitis and is correlated with disease activity. CONCLUSIONS: Because PAF and cytokines may have an i mportant role in the pathogenesis of inflammatory bowel disease, their inhibition by specific antagonists, mediators, or other agents such a s steroids may have a potential therapeutic benefit in treatment and m anagement of these inflammatory diseases in the near future.