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, Volume 29, Issue 1–2, pp 4–7 | Cite as

Inflammation as a diagnostic keystone and its clinical implications, exemplified by the inflammatory bowel diseases

  • P. Riis
Opening Lectures

Abstract

Inflammation is a complex process following sublethal injury to tissue and ends with permanent destruction of tissue or with healing. Inflammation has long, long roots in the evolutionary process and as a concept reaches far back in the history of medicine. Inflammation can not be viewed solely in a teleological perspective. Refined by phylogenesis it serves the integrity and survival of groups (species etc.) and not primarily individuals. Inflammation has, in the history of science, been studied on the macroscopic, the microscopic, the dynamic cellular, the immunological, the biochemical/physiological, and the molecular level. Clinicians have for centuries relied on inflammatory signs and symptoms in their diagnostics, even to the extent of being seriously confused, when a subject's inflammatory preparedness is disturbed, as in agranulocytosis, alcoholism, HIV-infection etc. Chronic inflammatory bowel diseases (ulcerative colitis and Crohn's disease) have been studied intensively by inflammologists. The results are partly exchangeable with studies in, for instance, chronic rheumatoid arthritis. They try to answer the over-all question in these diseases: Are we dealing with a normal inflammatory preparedness confronted with a special (unknown) agent, or an abnormal inflammatory preparedness confronted with an ubiquitous agent? The answer will form the basis for future treatment of these patients, whose diseases remind us of inflammation as man's fellow traveller on “the long phylogenetic march”.

Keywords

Rheumatoid Arthritis Arthritis Inflammatory Bowel Disease Evolutionary Process Ulcerative Colitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. [1]
    R. H. Ebert and L. Grant,The experimental approach to the study of inflammation. InThe Inflammatory Process (Eds. B. W. Zweifach, L. Grant and R. T. McCluskey) Academic Press, New York, San Francisco, London 1974.Google Scholar
  2. [2]
    P. Riis and V. Binder,Epidemiological data of chronic inflammatory bowel diseases in the Copenhagen, region. Front Gastrointest Res.11, 42–53 (1986).Google Scholar
  3. [3]
    P. Riis,The cytology of inflammatory exudate: a study on normal subjects and on patients showing quantitative or qualitative changes of the white blood picture. Munksgaard, Copenhagen 1959.Google Scholar
  4. [4]
    H. R. Wulff,Morphological and histochemical features of leucocytes in experimental inflammation and in disease. Munksgaard, Copenhagen 1967.Google Scholar
  5. [5]
    V. Binder,Colitis ulcerosa: belyst ved studier af colonslimhinden. FADL, Copenhagen. Århus, Odense 1972.Google Scholar
  6. [6]
    K. Bukhave, K. Gréen and J. Rask-Madsen,Comparison of radioimmunological determinations with gas chromatography mass spectrometry dosage: a study of PGE 2 and PGF 2α in gastrointestinal fluids. Biomed Mass Spectrom10, 265–268 (1983).PubMedGoogle Scholar
  7. [7]
    K. Bukhave and J. Rask-Madsen,Saturation kinetics applied to in vitro effects of low prostaglandin E 2 and F 2α concentrations on ion transport across human jejunal mucosa. Gastroenterology78, 32–42 (1980).PubMedGoogle Scholar
  8. [8]
    K. Bukhave and J. Rask-Madsen,Prostaglandin E 2 in jejunal fluids and its potential diagnostic value for selecting patients with indomethazin-sensitive diarrhoea. Eur J Clin Invest.11, 191–197 (1981).PubMedGoogle Scholar
  9. [9]
    J. Elmgreen,Complement and function of neutrophils in chronic inflammatory howel disease. Lægeforeningens Forlag, Copenhagen 1986.Google Scholar
  10. [10]
    J. H. Wandall,Neutrophilic granulocyte function: quantitative leukocyte mobili-ation and function of circulating and exudative neutrophils. Lægeforeningens Forlag, Copenhagen 1988.Google Scholar
  11. [11]
    O. H. Nielsen,In vitro studies on the significance of arachonidate metabolism and other oxidative processes in the inflammatory response of human neutrophils and macrophages Scand. J Gastroent, Vol. 23, suppl. 150 (1988).Google Scholar
  12. [12]
    B. D. Davidsen,Concanavalin A induced suppressor activity exerted by peripheral blood mononuclear cells with special reference to chronic inflammatory bowel disease. Lægeforeningens Forlag, Copenhagen 1988.Google Scholar
  13. [13]
    H. Marcussen,Colitis ulcerosa og colon-antistof. Copenhagen 1979.Google Scholar
  14. [14]
    J. Brynskov, V. Binder and P. Riis,Clinical experience with ciclosporin (cyclosporin A) in chronically-active, therapy-resistant Crohn's disease: a pilot study. Gastroenterology92, 1330 (1987).Google Scholar

Copyright information

© Birkhäuser Verlag 1990

Authors and Affiliations

  • P. Riis
    • 1
  1. 1.Medical Gastroenterological Department, Herlev University HospitalUniversity of CopenhangenHerlevDenmark

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