J. Schölmerich - Böcker

Zinc has an important role in human physiology due to its involvement in numerous enzymatic reactions and its other functions as part of hormones and structural proteins. As a consequence a wide variety of symptoms may occur in different states of zinc deficiency. Several diseases of the digestive tract can lead to zinc deficiency and consequently to deficiency symptoms. This volume, the proceedings of an International Falk Workshop held in Freiburg, Germany, on 27 October 1996, aims at a dialogue between basic researchers and gastroenterologists in order to improve the understanding of the role of zinc in disorders of the digestive tract. Based on lectures on the role of zinc in cell biology, the pathophysiology of zinc deficiency and consequently the possibilities of zinc substitution in these disorders is discussed. It is hoped that this book will initiate fruitful discussions and collaborations leading to a better knowledge of the role of this trace element in gastroenterology.

Most symposia on chronic inflammatory bowel disease during the last few years have focused on new aspects of aetiology and pathophysiology. However, based on such new aspects, changes in diagnosis and treatment have been developed in recent years and some others are currently under investigation. This book, the proceedings of Falk Symposium 97: Clinical Challenges in Inflammatory Bowel Diseases - Diagnosis, Prognosis and Treatment, held in Switzerland in April 1997, summarizes these changes and new developments, discusses their value and defines further new approaches. The topics include primary diagnosis, definition of different patient groups, special problems of these patients in daily life and recent therapeutic principles.

The format of the Falk Symposium 106 on "Advances in Inflammatory Bowel Diseases", held in Brussels, Belgium, June 18-20, 1998, attempted to link the new insights into pathogenetic mechanisms with new therapeutic approaches, resulting in optimal information transfer. This book summarizes the findings. The classic therapeutic schemes were updated with a special focus on step-wise build-up of therapy. Ulcerative colitis and Crohn's disease remain a great therapeutic challenge to the medical community. Knowledge about the pathogenesis of these diseases has progressed rapidly but the cause of the diseases remains completely unknown. It has become clear that dysregulation of the mucosal immune system is the basis for the chronic evolution of the diseases in a genetically susceptible population.

Although the first description of patients with what we now call Crohn's disease or ulcerative colitis, was published well before 1900, both disorders seem to be diseases of the 20th century. At the very start of the 21st century, it therefore seems appropriate to look back and at the same time look forward, and to assess what knowledge has been gained during the last 100 years and in what direction research and thereby clinical practice will go in the future. This book, the proceedings of Falk Symposium No. 111 held in Freiburg, Germany, on June 19th and 20th, 1999, contains contributions from experienced senior scientists on the state of the art in pathophysiology, diagnosis and treatment, together with unpublished and new findings from young researchers. Basic scientists and clinicians are thereby involved in an exchange of information which will lead to new directions for future research and clinical management of inflammatory bowel diseases.

The gastrointestinal tract has a number of unique features. Its extensive surface is formed by a single layer of rapidly renewing cells, the intestinal epithelial cells. These cells are in contact with a number of other cell populations, including the largest part of the immune system, and with an excessive luminal antigen load, including vast numbers of bacteria. Furthermore two more organs, namely liver and pancreas, are part of the system. The rapid renewal of the epithelial layer, the interactions of different cell types, and the balance between cell proliferation and death, have been fascinating subjects of studies in recent years. Much has been learned, and cytokines have emerged as important mediators for all these interactions and homeostatic systems. This book, the proceedings of the Falk Symposium 113 on "Cytokines and Cell Homeostasis in the Gastrointestinal Tract", held in Regensburg, Germany, 16-18 September 1999, presents the papers from this forum for basic scientists and interested clinicians to exchange ideas, to discuss concepts and to plan further studies.

The aetiology of the chronic inflammatory bowel diseases -- Crohn's disease and ulcerative colitis -- is still enigmatic. The therapeutic approach has therefore traditionally focused on anti-inflammatory principles, including corticosteroids and aminosalicylates. Since a significant proportion of patients is steroid-dependent or refractory and because of the problematic side-effects of long-term systemic steroids, active immunosuppression has gained acceptance in the field. The classical immunosuppressants azathioprine and 6-mercaptopurine have long been evidence-based in IBD, but underused. Recently, methotrexate and cyclosporine have also been proven to be effective in certain situations. Newer drugs like tacrolimus, mycophenolate and others may be similarly useful but their potential is still unclear. Finally, the immune modifiers including IL-10 and TNF-antibodies have been successfully subjected to controlled trials. Other experimental drugs discussed in this book are on the horizon.This volume is the Proceedings of Falk Symposium 119 held in Freiburg-im-Breisgau, Germany, October 3--4, 2000, and covers systematically the field of immunosuppression in inflammatory bowel diseases. It is hoped that it will further the prudent use of these drugs in the proper clinical situations by increasing our understanding of both the mechanisms of action and the clinical benefit to the patient.

This volume details the proceedings of the Falk Symposium number 122 on "Inflammatory Bowel Disease - A Clinical Case Approach to Pathophysiology, Diagnosis, and Treatment", held in Bologna, Italy, on June 22-23, 2001. It deals with some major issues concerning genetics of IBD, pediatrics in IBD, early versus late IBD, bacteria and gut inflammation, refractory CD, fistulizing CD, refractory distal colitis and complications of ileal-pouch anastomosis. The main aim of the meeting was to highlight the value of an integrated clinical approach and the importance of clinical research in developing innovative methods of treatment.

The first gene responsible for Crohn's disease has now been identified and the pathophysiological understanding of inflammatory bowel disease as well as its practical treatment has made much progress in the early-21st century. Thus it is obviously important to consider the targets and the aims of treatment in context. The Falk Symposium No. 131 (Part II of the Gastroenterology Week Freiburg 2002), held in October 2002 in Freiburg, Germany, in its first part was dedicated to newly defined and partly alternative therapeutic targets. In addition, an attempt was made to learn from experts from other fields such as pneumology or dermatology. The second part was dedicated to the aims of treatment in daily practice. Aside from general treatment, aims such as amelioration of symptoms, pre-conditions of treatment, the view of the patients, and aspects of life quality were dealt with. This volume is the proceedings of the symposium and is useful reading for both clinicians and basic scientists.

In recent years considerable progress has been achieved in regard to our understanding of the induction and modulation of the immune response in the intestinal mucosa. It is clear that this mucosal immune reaction is predominantly steered by certain T-cell populations, which are characterized by their cytokine secretion profile. Less well known are the conditions under which the uptake and processing of a specific antigen leads to a certain immune response, whether it be protective, tolerant or inflammatory. However, here again distinct progress has been made in our understanding. Equally significant for immune regulation in the gut appears to be so-called innate immunity. Every shift of equilibrium in the highly regulated mucosal immune reaction is accompanied by an inflammatory reaction and destruction of the mucosa. In nearly all cases, this inflammatory response is dependent on the presence of bacterial intestinal flora.This book, the proceedings of Falk Symposium 133 on Mechanisms of Intestinal Inflammation: Implications for Therapeutic Intervention in IBD', held in Berlin, Germany, on 10-11 June 2003, summarizes present knowlege in the area of unspecific and specific immune reactions in the gut, recording the gaps in our knowledge and, in particular, presenting the possibilities of targeted intervention. The link to inflammatory bowel diseases - Crohn's disease and ulcerative colitis - is always in focus. Chapters by an international panel of basic scientists, clinical researchers and clinicians also record the problems which can originate through today's possible modulation of the immune reaction, setting the basis for review of clinical problems. This book is valuable readings for all scientists and physicians, who, from different perspectives, have an interest in research on IBD and in the clinical management of these diseases.

Portal hypertension is causally related to major complications of chronic liver disease like upper GI tract bleeding, ascites formation, portosystemic encephalopathy and bacterial infections. Recent approaches have increased knowledge of the underlying pathobiological events of these complications. Accordingly, promising treatment modalities have been developed and introduced into clinical trials. This book, the proceedings of the 79th Falk Symposium in Freiburg-im-Breisgau, 17-19 June 1994, presents the recent developments in the field, including a section which describes the role of portal hypertension in the pathogenesis of complications of chronic liver disease. Also covered is the therapeutic management of portal hypertension and its consequences as well as the latest endoscopic, interventional and surgical treatment options.

Between the 1950s and 1980s, Europe and North America saw an increase in the incidence of Crohn’s disease in adults. The incidence of paediatric Crohn’s disease has grown and we are now entering a new era, in which inflammatory bowel disease (IBD), is emerging in the Asia-Pacific nations. This book presents the first major text where "East meets West" in IBD. The issues in the regions where IBD is a relatively common disease include the role of genetic and environmental factors in pathogenesis and disease expression, the application of diagnostic tools, and the use of biological agents in therapy. In contrast, key issues in the nations where IBD is at present relatively rare include characterising the nature and behaviour of IBD in those populations, developing ways of differentiating IBD from infective bowel conditions, eg. tuberculosis, how to apply standard treatment regimens, and the role of traditional therapies, such as Traditional Chinese Medicine, in the management of IBD.