Tomotaka Tanaka and Abbi Saniabadi,
Ulcerative Colitis, a Debilitating Inflammatory Bowel Disease: How to Treat Without Drugs
By the power of colonoscopy over a decade in patients with UC, we have learnt that all patients with the first UC episode and short duration of disease readily respond to GMA and can be spared from multiple drug therapy. Similarly, moststeroid naïve or dependent patients who have a fair level of intact mucosal tissue are potential responders to GMA. Additionally, it is important to bear in mind that patients who respond to GMA and avoid pharmacologics from the initial stages of their UC continue to respond well and attain a favourable future clinical course. Patients with extensive loss of the mucosal tissue together with
a long history of exposure to multiple pharmacologics are unlikely to respond to GMA. Further,GMA with the Adacolumn is very much favoured by patients for its safety profile. Serious side effects are very rare. This is in sharp contrast to multiple severe side effects associated with most conventional pharmacologics and new biologics. Our view is that in patients with UC, there is an evolving scope for therapeutic opportunity based on taking away the sources of inflammatorycytokines. However, selective depletion of activated and elevated myeloid lineage leucocytes to achieve IBD remission by applying GMA represents an intrigue, but this is yet to be achieved in all treated patients.
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