In Crohn's disease, immune damage to the gut wall is both induced and modified by the gut microflora, challenging researchers to solve the maze of interactions exploitable for therapeutic benefit. Whether these microbial 'guests' are worsening or helping in this scenario is still open to debate. In 'Bench to Bedside', Warren Strober highlights mice studies showing that certain microbes in the gut have a protective role promoting a shift towards an increased regulatory response that protects from recurrence of the disease. In 'Bedside to Bench', Thomas MacDonald examines how human studies using strategies to block soluble proinflammatory cytokines—despite solid supporting data from animal models—have shown disappointing results compared with therapies that neutralize soluble cytokines but also deplete proinflammatory cells, calling into question whether targeting a single soluble cytokine will ever be useful to treat people with Crohn's disease.
Traumatic brain injury (TBI) is an unfortunately common cause of death and disability among people of all ages. In addition to the primary injury to the brain resulting from the initial impact, a variety of secondary injuries contribute to morbidity stemming in part from high intracranial pressure (ICP) and resultant reductions in cerebral perfusion, leading to ischemia. Therapy to minimize this secondary injury includes ICP management, and a recent trial (Bulger et al, 2010) examined whether rapid administration of hypertonic fluids, a well-known measure that reduces ICP, would lead to better outcomes in TBI patients.
Marcel J. Casavant
Chief, Pharmacology-Toxicology, Nationwide Children's Hospital; Medical Director, Central Ohio Poison Center; Clinical Professor, The Ohio State University Colleges of Medicine and Pharmacy
Jill RK Griffith
Clinical Pharmacist, Mount Carmel West Hospital; Clinical Assistant Professor, The Ohio State University College of Pharmacy
David J. Kuter, M.D., D.Phil., Mathias Rummel, M.D., Ralph Boccia, M.D., B. Gail Macik, M.D., Ingrid Pabinger, M.D., Dominik Selleslag, M.D., Francesco Rodeghiero, M.D., Beng H. Chong, M.D., Xuena Wang, Ph.D., and Dietmar P. Berger, M.D., Ph.D.