152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...

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Interview 26 concepts but have also learned new tips and tricks for dealing with difficult situations. There are other viewers who, although they themselves do not perform endoscopy, have taken advantage of this event to update their knowledge on the current perspectives of this method. Hence, practically every viewer, regardless of his own expertise, can find information that will help him in his own practice. Another advantage of a liver demonstration is that the situations are authentic and the cases are real. One can follow along directly and see what happens during the procedure. ? What has been the development of endoscopy and what is its current role? ! Schulz: The development of endoscopy over the past years and decades has been unbelievably exciting. Again and again, we have had the impression that we have been working on the cutting edge and that further improvements were practically impossible. Again and again, however, there were spectacular leaps that significantly advanced both the diagnostic and, more recently, also the therapeutic potential of endoscopic procedures. Starting with the normal optic endoscopes, we soon advanced to the flexible optical fiber units. Then came the leap to videoendoscopy that continued to improve and add new features, particularly in terms of magnification and color techniques. Currently, we are experiencing another technological leap. Image resolution has become significantly better and we have benefited from new technologies, such as narrow band imaging, with which we can visualize vasculature and thus better assess areas suspicious for malignancy. Endoscopy continues to develop into a more therapeutically relevant method. In addition, pathology of the biliary tract and the pancreas is now increasingly amenable to endoscopic treatment, sparing patients the risks of conventional open surgery. Using the doubleballoon technique, we can now reach all regions of the gastrointestinal tract without surgery. Biopsies can be obtained, pre-cancerous and early-stage tumors can be removed and other disorders can be therapeutically addressed. Besides this, further advances are occurring, including capsule endoscopy, which is already being used and developed, as well as other endoscopic technologies. The relevance of virtual endoscopy cannot, however, be definitively assessed at this time. Professor Schulz, thank you for the interview.
Session 1 Congress Short Report Falk Symposium 153 Falk Symposium 153 Immunoregulation in Inflammatory Bowel Diseases – Current Understanding and Innovation Berlin, May 6–7, 2006 Advances in the Pathogenesis of IBD Chair: A. Dignass, Frankfurt D. Rachmilewitz, Jerusalem Inflammatory bowel diseases: strong genetic components Inflammatory bowel diseases (IBD) such as Crohn’s disease (CD) and ulcerative colitis (UC) usually manifest themselves in adolescents or young adults. Their incidence has been increasing over the past decades and, according to S. Schreiber (Kiel), it occurs more frequently in some families. This, together with the high concordance in monozygotic twins (over 55%), which is not observed in fraternal twins (under 5%), supports the hypothesized strong genetic component of these diseases. IBD are polygenetic diseases, although recent research has identified the NOD2 (CARD15) gene that potentially acts as a trigger in the pathogenesis of Crohn’s disease (figure 18). According to S. Schreiber, NOD2 belongs to a large family of S. Schreiber proteins involved in defending the organism from bacterial invasion. “NOD2, however, is not by far the only component of the pathomechanism of inflammatory bowel diseases,” S. Schreiber said. Corresponding mutations are involved in the disease process in less than half of all patients (figure 19), which means that the search must continue for further potential pathogenetic factors. Like NOD2, some other factors may involve chromosome 16, on which several areas have been identified that may be involved in the development of IBD. Here, S. Schreiber said, gene splicing may play a role. This process, in which RNA fragments of varying length and corresponding protein fragments are produced, lends high plasticity to the human genome. 27
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