ULCERATIVE COLITIS – EPIDEMIOLOGY, PATHOGENESIS AND COMPLICATIONS Edited by Mortimer B. O'Connor Ulcerative Colitis – Epidemiology, Pathogenesis and Complications Edited by Mortimer B. O'Connor Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Danijela Duric Technical Editor Teodora Smiljanic Cover Designer InTech Design Team Image Copyright kaarsten, 2011. Used under license from Shutterstock.com First published November, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Ulcerative Colitis – Epidemiology, Pathogenesis and Complications, Edited by Mortimer B. O'Connor p. cm. ISBN 978-953-307-880-9 Contents Preface IX Part 1 An Introduction to Ulcerative Colitis 1 Chapter 1 Ulcerative Colitis 3 Iftikhar Ahmed and Zafar Niaz Chapter 2 Proteomic Approaches for Biomarker Discovery in Ulcerative Colitis 13 Manae S. Kurokawa, Moriaki Hatsugai, Yohei Noguchi, Takuya Yoshioka, Hiroyuki Mitsui, Hiroshi Yasuda and Tomohiro Kato Part 2 Pathogenesis 27 Chapter 3 Enteric Nervous System Abnormalities in Ulcerative Colitis 29 Carla Cirillo, Giovanni Sarnelli and Rosario Cuomo Chapter 4 Protein Kinases and Ulcerative Colitis 51 Yutao Yan Chapter 5 CXCL12-CXCR4 Axis in Ulcerative Colitis 71 Hiroshi Nakase, Minoru Matsuura, Sakae Mikami and Tsutomu Chiba Chapter 6 Defensins in Ulcerative Colitis 79 Zhanju Liu and Yurong Yang Chapter 7 Role of Interferon -γ-Inducible Protein (IP)-10/ (IP-10/CXCL10) in Ulcerative Colitis; A Review of the Present Status 103 Kenji Suzuki, Hiroyuki Yoneyama and Hitoshi Asakura Chapter 8 Molecular Determinants in Ulcerative Colitis – Epigenetics and Telomere Dysfunction 117 Ramesh P. Arasaradnam and Chuka U. Nwokolo VI Contents Part 3 Complications 129 Chapter 9 Extraintestinal Manifestations of Ulcerative Colitis 131 Brian Huang, Lola Y. Kwan and David Q. Shih Chapter 10 Kallikrein – Kinin System and Coagulation System in Inflammatory Bowel Diseases 173 Antoni Stadnicki Chapter 11 Ulcerative Proctitis 197 Gino Caselli Morgado and George Pinedo Mancilla Chapter 12 Inflammatory Bowel Disease and Primary Sclerosing Cholangitis 207 Gulbanu Erkan Chapter 13 Neoplasia in IBD 227 Joel Pekow and Marc Bissonnette Chapter 14 Mucosal Remodeling and Alteration of Stromal Microenvironment in Ulcerative Colitis as Related to Colorectal Tumorigenesis 241 Isao Okayasu, Tsutomu Yoshida, Tetuo Mikami, Jun Mitsuhashi, Masaaki Ichinoe, Nobuyuki Yanagisawa, Wataru Tokuyama, Kiyomi Hana and Yuichi Ishibashi Chapter 15 Ulcerative Colitis and Lung 257 Nilgün Yılmaz Demirci Chapter 16 Nephritis Associated with Ulcerative Colitis 271 Hirobumi Tokuyama, Shu Wakino, Koichi Hayashi and Hiroshi Itoh Preface Gastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words gaster (gastros or stomach), enteron (intestine), and logos (reason). Its documented history dates back to Egyptian times where, citing from Egyptian papyri, Nunn identified significant knowledge of gastrointestinal diseases among practicing physicians during the periods of the pharaohs. Irynakhty, of the tenth dynasty, c. 2125 B.C., was a court physician specializing in gastroenterology and proctology. Among ancient Greeks, Hippocrates attributed digestion to concoction, while Galen’s concept of the stomach having four faculties was widely accepted up to modernity in the seventeenth century. Since then, the works of several scholars has evolved the thinking of gastroenterology, such as Maximilian Stroll in 1777, who described cancer of the gallbladder, and Karl Wilhelm von Kupffer in 1876, who described the properties of liver Kupffer cells. Others include Burrill Bernard Crohn in 1932, who described Crohn’s disease, and Barry Marshall, Robin Warren and James Leavitt in 1982/1983 with the discovery of Helicobacter pylori and its role in peptic ulcer disease. It is clearly seen, by the history of Gastroenterology, that the speciality continues to develop at a rapid pace due to increase of understanding of disease processes and the discovery of new diagnostic and treatment strategies. Ulcerative Colitis is no exception to this trend. This book is just another step in marking the current developing knowledge and thinking around the area of Ulcerative colitis. This book, which is divided into 2 volumes, is intended to act as an up-to-date reference point and knowledge developer for all readers interested in the area of gastroenterology, and in particular, Ulcerative Colitis. All authors of the chapters are experts in their fields of publication, and deserve individual credit and praise for their contributions to the world of Ulcerative Colitis. We hope that you will find this publication informative, stimulating, and a reference point for the area of Ulcerative colitis as we move forward in our understanding of the field of medicine. With that hope, I remind you of the though provoking quote by the French Philosopher and writer, Voltaire (1694 – 1778), “Doctors are men who prescribe medicines of which they know little, to cure disease of which they know less, in human beings of whom they know nothing”. X Preface Acknowledgements Many thanks to the authors of each Chapter of this book. The outstanding contributions they have made resulted in a very easy book to edit. It was very enjoyable and a privilege reading each contribution. Your work is now a mark for the future. To the publisher, InTech, thank you for being ever present and encouraging me in my endeavors to stay up to date with the review and editing process. I would never have been so organized without the assistance of Ms. Danijela Duric, Publishing Process Manager. It was a pleasure to edit my first book with such a wonderful group. To my father (Tim) and late mother (Eileen), thank you for all the encouragement over the years to achieve my goals and become the ever developing doctor that I am today. I could not have achieved a fraction of my success without the support and love. Mam, I know you are always watching over and guiding me from a place nearby. Dr Catherine O’Connor, my late aunt, who was always an inspiration. The ever present support and guidance in my early years of life and career were far beyond the role of an aunt or godmother. You will always be an example of professionalism that I will strive to achieve. Finally, to my other half, Bernie. All those long evenings spent without me while I was reading chapters and doing background knowledge discovery for this book are finally over. Your support is always beyond the call of duty and appreciated. Thank you. Mortimer B. O’Connor Department of Medicine, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland . ULCERATIVE COLITIS – EPIDEMIOLOGY, PATHOGENESIS AND COMPLICATIONS Edited by Mortimer B. O'Connor Ulcerative Colitis – Epidemiology, Pathogenesis and Complications. history, stool frequency and consistency, urgency, rectal bleeding, abdominal pain, malaise, fever, weight loss, and Ulcerative Colitis – Epidemiology, Pathogenesis and Complications 6 symptoms. steroid-refractory. Treatment of CMV may obviate Ulcerative Colitis – Epidemiology, Pathogenesis and Complications 8 colectomy. Care should be taken to monitor and correct electrolytes on a daily basis