[Recent knowledge of the pathophysiology of inflammation in Crohn disease and ulcerative colitis: possible sequelae for future treatment concepts].

Increasing knowledge of intestinal inflammatory processes in inflammatory bowel diseases has been obtained in the last five years based on clinical, immunologic and biochemical studies. The intestinal inflammatory response presently is believed to evolve in three stages, the first being heralded by immunologic events, the second being characterized by the production of inflammatory mediators with amplification of this response, the third being led by destructive interactions of activated inflammatory cells with the gut epithelium. Pharmacologic intervention at each of these stages is regarded a desirable therapeutic goal in the absence of a known etiology. Phospholipase-A2 and lipoxygenase inhibitors, radical scavengers, mediator receptor antagonists or modification of mediators with less active derivatives are examples of recent developments. The next future, however, will show us, which of these concepts may be realized clinically.