Table of Contents
ISRN Gastroenterology
Volume 2011 (2011), Article ID 194324, 5 pages
http://dx.doi.org/10.5402/2011/194324
Review Article

Immunomodulators and Immunosuppressants for Japanese Patients with Ulcerative Colitis

1Division of Gastroenterology, Shiga University of Medical Science, Shiga 521-2192, Japan
2Division of Clinical Nutrition, Shiga University of Medical Science, Shiga 521-2192, Japan
3Division of Mucosal Immunology, Graduate School of Medicine, Shiga University of Medical Science, Shiga 521-2192, Japan

Received 17 February 2011; Accepted 1 April 2011

Academic Editors: J. M. Pajares and C. C. Schimanski

Copyright © 2011 Shigeki Bamba et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ulcerative colitis (UC) is characterized by a long-standing chronic course with remissions and exacerbations. Previously, patients do not respond to 5-aminosalicylic acid compounds and corticosteroids are considered for colectomies, however, in recent years, alternative treatments emerged for steroid-refractory or steroid-dependent UC. In this review article, we focus on immunomodulators (such as azathioprine [AZA] and 6-mercaptopurine [6-MP]) and immunosuppressants (such as cyclosporine A [CSA] and tacrolimus [FK506]) for steroid-refractory or steroid-dependent ulcerative colitis. The characteristics, efficacy and adverse effects of these drugs are outlined. Although the randomized trial of FK506 is conducted in Japan, the clinical data of CSA in Japanese patients are limited. The short-, mid- and long-term follow-ups of CSA administration in Japanese patients are discussed. As for thipurine drugs, the clinical importance of multidrug-resistance protein 4 (MRP4) in Japanese patients is highlighted.