Most Fractures Treated Nonoperatively in Individuals With Fibrodysplasia Ossificans Progressiva Heal With a Paucity of Flareups, Heterotopic Ossification, and Loss of Mobility.

BACKGROUND: Fibrodysplasia ossificans progressiva (FOP) is an ultrarare genetic disorder with episodic and progressive heterotopic ossification. Tissue trauma is a major risk factor for flareups, heterotopic ossification (HO), and loss of mobility in patients with FOP. The International Clinical Council on FOP generally recommends avoiding surgery in patients with FOP unless the situation is life-threatening, because soft tissue injury can trigger an FOP flareup. Surprisingly little is known about flareups, HO formation, and loss of mobility after fractures of the normotopic (occurring in the normal place, distinct from heterotopic) skeleton when treated nonoperatively in patients with FOP. QUESTIONS/PURPOSES: (1) What proportion of fractures had radiographic evidence of union (defined as radiographic evidence of healing at 6 weeks) or nonunion (defined as the radiographic absence of a bridging callus at 3 years after the fracture)? (2) What proportion of patients had clinical symptoms of an FOP flareup because of the fracture (defined by increased pain or swelling at the fracture site within several days after closed immobilization)? (3) What proportion of patients with fractures had radiographic evidence of HO? (4) What proportion of patients lost movement after a fracture? METHODS: We retrospectively identified 36 patients with FOP from five continents who sustained 48 fractures of the normotopic skeleton from January 2001 to February 2021, who were treated nonoperatively, and who were followed for a minimum of 18 months after the fracture and for as long as 20 years, depending on when they sustained their fracture during the study period. Five patients (seven fractures) were excluded from the analysis to minimize cotreatment bias because these patients were enrolled in palovarotene clinical trials (NCT02190747 and NCT03312634) at the time of their fractures. Thus, we analyzed 31 patients (13 male, 18 female, median age 22 years, range 5 to 57 years) who sustained 41 fractures of the normotopic skeleton that were treated nonoperatively. Patients were analyzed at a median follow-up of 6 years (range 18 months to 20 years), and none was lost to follow-up. Clinical records for each patient were reviewed by the referring physician-author and the following data for each fracture were recorded: biological sex, ACVR1 gene pathogenic variant, age at the time of fracture, fracture mechanism, fracture location, initial treatment modality, prednisone use at the time of the fracture as indicated in the FOP Treatment Guidelines for flare prevention (2 mg/kg once daily for 4 days), patient-reported flareups (episodic inflammatory lesions of muscle and deep soft connective tissue characterized variably by swelling, escalating pain, stiffness, and immobility) after the fracture, follow-up radiographs of the fracture if available, HO formation (yes or no) as a result of the fracture determined at a minimum of 6 weeks after the fracture, and patient-reported loss of motion at least 6 months after and as long as 20 years after the fracture. Postfracture radiographs were available in 76% (31 of 41) of fractures in 25 patients and were independently reviewed by the referring physician-author and senior author for radiographic criteria of fracture healing and HO. RESULTS: Radiographic healing was noted in 97% (30 of 31) of fractures at 6 weeks after the incident fracture. Painless nonunion was noted in one patient who sustained a displaced patellar fracture and HO. In seven percent (three of 41) of fractures, patients reported increased pain or swelling at or near the fracture site within several days after fracture immobilization that likely indicated a site-specific FOP flareup. The same three patients reported a residual loss of motion 1 year after the fracture compared with their prefracture status. HO developed in 10% (three of 31) of the fractures for which follow-up radiographs were available. Patient-reported loss of motion occurred in 10% (four of 41) of fractures. Two of the four patients reported noticeable loss of motion and the other two patients reported that the joint was completely immobile (ankylosis). CONCLUSION: Most fractures treated nonoperatively in individuals with FOP healed with few flareups, little or no HO, and preservation of mobility, suggesting an uncoupling of fracture repair and HO, which are two inflammation-induced processes of endochondral ossification. These findings underscore the importance of considering nonoperative treatment for fractures in individuals with FOP. Physicians who treat fractures in patients with FOP should consult with a member of the International Clinical Council listed in the FOP Treatment Guidelines ( https://www.iccfop.org ). LEVEL OF EVIDENCE: Level IV, therapeutic study.

Treatment options for oropharyngeal carcinoma - An umbrella review.

INTRODUCTION: Our umbrella review aimed to summarize and revisit the evidence from all of the meta-analyses and systematic reviews regarding the treatments of oropharyngeal squamous cell carcinoma (OPSCC). MATERIALS AND METHODS: Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library, BIOSIS, and EBSCO were searched. The overall search process was conducted in 3 stages. RESULTS: Finally, a total of 28 studies met the inclusion criteria and were included in this study. Out of those 28 meta-analyses, a total of 315 primary studies were screened in order to extract the data and perform the statistical analysis. In total, data from 22,619 patients was analyzed. CONCLUSION: The main objective of the present umbrella review was to summarize and analyze all of the evidence-based data provided by numerous meta-analyses and systematic reviews regarding the treatment of OPSCC. Our study delivers the most up-to-date and evidence-based results regarding the different therapeutic modalities of this malignancy in one concise review, making it the ultimate tool for physicians treating OPSCC.

Coincidence of selective immunoglobulin A deficiency in juvenile idiopathic arthritis - a series of three cases.

Immunoglobulin A (IgA) deficiency is the most common primary immunodeficiency in humans, with incidence depending on ethnic background and the highest frequency in Caucasians. Selective IgA deficiency may have an asymptomatic course and constitute a random laboratory finding with no clinical manifestation. There is, however, a group of patients with increased incidence of recurrent upper respiratory tract infections, allergies, asthma, atopic dermatitis and other pathologies connected with IgA deficiency. This group of patients often needs broad-spectrum antibiotic therapy with maximum doses and extended time of treatment as there is no causal treatment for IgA deficiency. An association between IgA deficiency and autoimmune diseases, such as juvenile idiopathic arthritis, has been proved before. Nonetheless, the frequency of co-occurrence of these disorders in an individual as well as the way immunodeficiency may influence the course of juvenile idiopathic arthritis is still undefined, with limited literature on this topic. This article presents case reports of three pediatric patients with confirmed co-occurrence of IgA deficiency and oligoarticular juvenile idiopathic arthritis.

[Could the cytokines concentration be a marker of IBD activity and be useful in evaluation of IBD differentiation?]

Background: In inflammatory bowel disease (IBD) the imbalance between cytokines pro- and antinflammatory is observed. The aim of this study was the assessment of interleukin-10 (IL-10), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentration usefulness in the evaluation of the activity of ulcerative colitis (UC) and Cohn's disease (CD). Methods: 35 patients diagnosed with UC and 39 with CD were examined. The control group (CG) consisted of 35 healthy volunteers. Diagnosis of the disease was confirmed by videocolonoscopy and histopathological evaluation of intestinal biopsies. Disease activity of UC was assessed according to the Mayo Scoring System and by the Crohn Disease Activiti Index (CDAI) in CD patients. Among patients with UC 18 (51%) had severe, 14 (40%) moderate and 3 (9%) mild disease. Among patients with CD 7 (18%) was diagnosed with high, 27 (69%) moderate, and 5 (13%) with low activity of the disease. WBC, PLT, serum concentration of TNF-α, IL-6 i IL-10 were determined. Results: The average concentration of TNF-α in UC patients was: 14.3 (IQR=12.6), in CD: 12.6 (IQR=11.9), in the CG: 3.1 (IQR=1.7). The average concentration of IL-6 in UC was: 19.6 (IQR=21), in CD: 10.8 (IQR=7.6), in CG : 3.2 (IQR=1.6). The average concentration of IL-10 in UC was: 14.4 (IQR=5.9), in CD: 10.4 (IQR=9.3), in the CG: 3.3 (IQR=2.5). In the IBD TNF-α, IL-6 and IL-10 concentration was significantly higher than in CG. However, IL-10 was significantly higher in UC than CD. In patients with UC statistically significant positive correlation between the concentration of TNF-α, IL-6 and IL-10 and disease activity was noticed. There were no correlation between TNF-α, IL-6 and IL-10 concentration and CD activity. Conclusion: Determination of TNF-α, IL-6 and IL-10 serum concentration can be used for noninvasive evaluation of inflammation activity in patients with IBD. IL-10 concentration may be helpful in differentiation of UC and CD.

TGF-ß1 and granulocyte elastase in the evaluation of activity of inflammatory bowel disease. A pilot study.

INTRODUCTION: The aim was to assess the usefulness of TGF-ß1 and elastase in the evaluation of activity of ulcerative colitis (UC) and Crohn's disease (CD). MATERIAL AND METHODS: 32 patients diagnosed with UC, 31 with CD and 30 healthy volunteers were enrolled in this study. Diagnosis of the disease was confirmed by videocolonoscopy and histopathological evaluation of intestinal biopsies. Disease activity was assessed by use of the Mayo Scoring System for Assessment of Ulcerative Colitis Activity in UC patients and by CDAI in CD patients. hsCRP was determined by the immunonephelometric method, TGF-ß1 and elastase plasma concentration by ELISA. The results of the study were analyzed using Statistica and R statistical language. RESULTS: In UC a positive correlation between disease activity and platelet level, hsCRP and TGF-ß1 concentration was noted. Elastase concentration in UC patients was significantly higher than in CD, but there was no correlation with the activity of the disease. In CD patients we observed a positive correlation between disease activity and leukocytes, platelet levels and elastase concentration, and a very low correlation with hsCRP and TGF-ß1. DISCUSSION: Determination of TGF-ß1 can be used for evaluation of inflammatory activity in UC and it is connected with elevated concentrations of CRP and platelets. To a lower extent TGF-ß1 can also be used for evaluation of inflammatory activity in CD. Examination of elastase concentration may be useful in the assessment of CD activity. Plasma elastase concentration may be helpful in UC and CD differentiation. The preliminary results of this investigation seem promising; nevertheless, more studies are necessary.

Phytochemical Characterization and Biological Activities of Essential Oil from Satureja montana L., a Medicinal Plant Grown under the Influence of Fertilization and Planting Dates.

The rising demand for safe plant compounds and herbal products that contribute positively to human health is in line with current market trends. Plants belonging to the Satureja genus, particularly the aromatic medicinal S. montana L. from the Lamiaceae family, are well suited to these trends as they serve as pharmaceutical raw materials. This research aimed to assess the influence of sowing date and fertilization doses, as well as their interaction, on the fresh weight, essential oil content, and composition of S. montana. Experimental cultivation involved varying nitrogen and phosphorus levels. The second cut had the highest fresh weight and oil production compared to the first cut. The highest total plant biomass was achieved with autumn sowing and fertilization at 55 kg N/ha and 37 kg P/ha, whereas Spring sowing exhibited higher essential oil production, with the maximum oil % with 74 kg P/ha and oil yield after applying 55 kg N/ha and 74 kg P/ha. The GC-MS analysis revealed that carvacrol was the predominant compound, with it being recommended to grow S. montana in Spring at doses of 55 kg N/ha and 74 kg P/ha for the superior oil yield. Additionally, S. montana essential oil demonstrated notable biological and antimicrobial activity, positioning it as a potential alternative to chemical food preservatives.

Profile of phenolic compounds and antioxidant activity of organically and conventionally grown black-grain barley genotypes treated with biostimulant.

Beneficial dietary and pro-health values, have resulted in the increasing consumption importance of barley. Therefore, genotypes and cultivation methods are sought that guarantee high functional value of grain. The aim of the study was to assess the content of phenolic acids, flavonoids, chlorophylls, anthocyanidins, phytomelanin and antioxidant activity of grain of three barley genotypes depending on agricultural technology. Two of them are primary genotypes with dark grain pigmentation Hordeum vulgare L. var nigricans and H. vulgare L. var. rimpaui, the third is a modern cultivar 'Soldo' H. vulgare with yellow grain, which is the control sample. Evaluated the effect of foliar application of a amino-acids biostimulant on the functional properties of grain under the conditions of organically and conventionally cultivations. The results indicated a higher antioxidant activity and the concentration of phenolic acids, flavonoids and phytomelanin in the black-grain genotypes. Organic cultivation and application of amino acids had increased the content of phenolic compounds in grain. The antioxidant activity was correlated with the content of syringic acid, naringenin, quercetin, luteolin and phytomelanin. Organically cultivation and the foliar application of an amino acid biostimulant improved the functional properties of barley grain, in particular the original, black-grained genotypes.

The impact of spring wheat species and sowing density on soil biochemical properties, content of secondary plant metabolites and the presence of Oulema ssp.

The physical and chemical properties of the soil are important factors influencing the yield of crops. One of the agrotechnical factors influencing the biochemical properties of soil is sowing density. It affects the yield components, light, moisture and thermal conditions in the canopy and the pressure of pests. Secondary metabolites, many of which are known to act as a defense mechanism against insects, are of importance in the interaction between the crop and abiotic and biotic factors of the habitat. To the best of our knowledge, the studies conducted so far do not sufficiently reveal the impacts of the wheat species and the sowing density, together with the biochemical properties of the soil, on the accumulation of bioactive ingredients in the crop plants, and the subsequent impacts on the occurrence of phytophagic entomofauna in various management systems. Explaining these processes creates an opportunity for more sustainable development of agriculture. The study aimed to determine the effect of wheat species and sowing density on the biochemical properties of the soil, concentrations of biologically active compounds in the plant and the occurrence of insect pests in organic (OPS) and conventional (CPS) production systems. The research was conducted on spring wheat species (Indian dwarf wheat-Triticum sphaerococcum Percival and Persian wheat-Triticum persicum Vavilov) grown in OPS and CPS at sowing densities 400, 500, 600 (seeds m-2). The following analyzes were performed: (i) soil analysis: the activity of catalases (CAT), dehydrogenases (DEH), peroxidases (PER); (ii) plant analysis: total phenolic compounds (TP), chlorogenic acid (CA), antioxidant capacity (FRAP); (iii) entomological analysis of the number of insects-Oulema spp. adults and larvae. Performing analyzes in such a wide (interdisciplinary) scope will allow for a comprehensive understanding of the soil-plant-insect biological transformation evaluation. Our results showed that an increase in soil enzyme activity caused a decrease in TP contents in the wheat grown the OPS. Despite this, both the content of TP and the anti-oxidative activity of the ferric reducing ability of plasma (FRAP) were higher in these wheats. Bioactive compound contents and FRAP were most favoured by the lowest sowing density. Regardless of the production system, the occurrence of the Oulema spp. adults on T. sphaerococcum was the lowest at a sowing density of 500 seeds m-2. The occurrence of this pest's larvae was lowest at a sowing density of 400 seeds m-2. Research on bioactive compounds in plants, biochemical properties of soil and the occurrence of pests make it possible to comprehensively assess the impact of the sowing density of ancient wheat in the ecological and conventional production system, which is necessary for the development of environmentally sustainable agriculture.

Seaweed extract and arbuscular mycorrhiza co-application affect the growth responses and essential oil composition of Foeniculum vulgare L.

The influence of arbuscular mycorrhiza fungi (AMF) inoculation, seaweed extract (SWE) foliar use, and their co-applications were evaluated on the growth-associated traits, antioxidant potential, essential oil profile, and the nutrients content of fennel plants. A factorial experiment was conducted as a completely randomized design with two factors and four replications in the greenhouse. The factors were: AMF inoculation (not inoculated and inoculated with 5 g kg-1) and SWE foliar application (0, 0.5, 1.5, or 3 g L-1). The highest root colonization percentage was recorded in plants treated with AMF + 3 g L-1 of SWE. The top recorded plant height, leaf number, leaf dry weight, biomass, thousand seed weight (TSW), total soluble proteins and total soluble carbohydrates content, antioxidant activity, and essential oil content belonged to AMF + 3 g L-1 of SWE. Furthermore, the co-application of AMF + SWE resulted in a considerable enhancement of the photosynthetic pigments content and, in N, P, K, Fe, Zn, and Mn contents in the shoots and roots. The GC-FID and GC-MS analysis revealed that (E)-anethole (73.28-76.18%), fenchone (5.94-8.26%), limonene (4.64-6.58%), methyl chavicol (2.91-3.18%), and (Z)-ß-ocimene (1.36-2.01%) were the principal essential oil constituents. The top (E)-anethole and fenchone contents were obtained by AMF + SWE. Altogether, the simultaneous application of AMF and SWE could be introduced as an environment-friendly strategy to reach reliable growth responses, especially in fennel plants' enriched with some precious essential oil constituents.

Determination of the effect of abiotic stress on the oxidative potential of edible potato tubers.

Stress factors occurring during the growing season and potato storage, can negatively affect the quality of tubers, including an increased tendency to enzymatic darkening. Abiotic stress due to water shortage is a major factor limiting agricultural production. The purpose of the study was to determine the effect of cultivation technology based on the use of biostimulant, hydrogel and irrigation as well as storage on the propensity to darkening and the content of sugars and organic acids. The results show that genotypic and technological variability in interaction with growing season conditions had a significant (p < 0.05) effect on the oxidative potential (OP) of potato tubers. The Denar cultivar, compared to the 'Gardena', was characterized by a lower tendency to enzymatic darkening. Application of biostimulant and hydrogel generally contributed to lowering the oxidative potential of the tested cultivars. The application of anti-stress agents had no effect on organic acid content. The long-term storage caused an increase in the content of total sugars (TS) (22%), reducing sugars (RS) (49%), chlorogenic acid (ACH) (11%), and loss of ascorbic acid (AA) (6%) in the tubers which contributed to an increase in the oxidative potential of potato tubers (16%). The correlation coefficients obtained (p < 0.05) confirm the dependence of OP on the concentration of organic acids.

Garetosmab in fibrodysplasia ossificans progressiva: a randomized, double-blind, placebo-controlled phase 2 trial.

Fibrodysplasia ossificans progressiva (FOP) is a rare disease characterized by heterotopic ossification (HO) in connective tissues and painful flare-ups. In the phase 2 LUMINA-1 trial, adult patients with FOP were randomized to garetosmab, an activin A-blocking antibody (n = 20) or placebo (n = 24) in period 1 (28 weeks), followed by an open-label period 2 (28 weeks; n = 43). The primary end points were safety and for period 1, the activity and size of HO lesions. All patients experienced at least one treatment-emergent adverse event during period 1, notably epistaxis, madarosis and skin abscesses. Five deaths (5 of 44; 11.4%) occurred in the open-label period and, while considered unlikely to be related, causality cannot be ruled out. The primary efficacy end point in period 1 (total lesion activity by PET-CT) was not met (P = 0.0741). As the development of new HO lesions was suppressed in period 1, the primary efficacy end point in period 2 was prospectively changed to the number of new HO lesions versus period 1. No placebo patients crossing over to garetosmab developed new HO lesions (0% in period 2 versus 40.9% in period 1; P = 0.0027). Further investigation of garetosmab in FOP is ongoing. ClinicalTrials.gov identifier NCT03188666 .

Non-alcoholic fatty liver disease in Poland: how and at what stage is diagnosed, and how is treated. A survey study.

INTRODUCTION: Epidemiological studies show an increasing incidence of overweight and obesity all over the world, leading to an increase in the number of patients consulted due to liver damage. AIM: Assesement to which doctors (general practitioners or specialist) refer patients with elevated liver enzymes in Poland, how they are diagnosed and treated. MATERIAL AND METHODS: We conducted questionnaire surveys among 1322 doctors of various specialties to find the most common causes of liver disease, at which stage of the disease patients reported to doctors, and what schemes of management are followed. RESULTS: Non-alcoholic fatty liver disease (NAFLD) was the most common cause of abnormal liver enzymes (59.7%). Patients with liver damage most often reported to internal medicine specialists (59%) and gastroenterologists (27.5%). The diagnosis was based on abnormal aminotransferases (80.8%) and abdominal ultrasound examination (89.9%). Computed tomography/magnetic resonance imaging (50.2%) and liver biopsy (22.4%) were used to assess fibrosis. Almost all respondents recommended reduction of body mass and lifestyle changes, and less than half (46.4%) recommended pharmacological treatment. CONCLUSIONS: NAFLD was the most common liver disease that was the reason for medical consultations, but its incidence seems to be underestimated due to referral for further diagnostics only in patients with abnormal aminotransferases. The diagnostic methods used to assess the severity of the liver fibrosis and the recommended pharmacological treatment varied depending on the physician's specialisation and the centre's reference level.

Non-invasive diagnosis of steatosis, inflammatory changes and liver fibrosis in patients with non-alcoholic fatty liver diseases. Pilot study.

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of abnormal liver enzymes in adult patients consulted by hepatologists. Due to the high prevalence of this disease, most often associated with obesity, it is necessary to assess the risk of NAFLD, monitoring the progression of the disease and the effectiveness of treatment. MATERIAL AND METHODS: We evaluated the intensity of steatosis, inflammatory activity and fibrosis in 36 patients with NAFLD (fatty liver in abdominal ultrasound examination), using non-invasive tests: SteatoTest, ActiTest and FibroTest. We compared the prevalence of metabolic disorders and hypertension between women and men. RESULTS: There were no significant differences in analysed parameters of metabolic disorders between women and men. In both studied groups, the intensity of steatosis and inflammatory changes was similar. However, in the male group, the intensity of liver fibrosis was higher. CONCLUSIONS: The tests helped to detect advanced liver fibrosis in patients who were diagnosed with liver steatosis in ultrasound examination. Non-invasive diagnostics of liver injury may be useful in screening to select groups of patients requiring liver biopsy, as well as in monitoring the course of the disease and assessment of the treatment effectiveness. Early detection of liver disease may improve the prognosis of these patients.

[Serum cytokine concentration as prognostic factor in patients with alcoholic liver disease]. / Zastosowanie oznaczania cytokin w ocenie rokowania u chorych z alkoholowa choroba watroby.

AIM OF THE STUDY: Estimation if the serum concentration of cytokines: IL-2, IL-4, IL-6, IL-8, IL-10, TNF-alfa and CRP can be useful in the assessment of prognosis in patients with alcoholic hepatitis (ALH) and alcoholic liver cirrhosis (ALC). Attempt to find their correlation with clinical stage and life prognosis in all patients. MATERIALS AND METHODS: We examined 24 patients with alcoholic liver disease, hospitalised in Department of Gastroenterology: 13 male and 11 female at the age 26-72 years. According to clinical symptoms and laboratory tests in 15 of them alcoholic hepatitis (in 9 confirmed by liver biopsy) and in 9 - liver cirrhosis (2 confirmed by liver biopsy) were diagnosed. The interview, physical examination, abdominal ultrasound, biochemical tests and viral tests were performed in all patients. We excluded patients treated with steroids and cytostatics. Serum concentration of cytokines and CRP were established three times during the first week of hospitalisation. RESULTS AND CONCLUSIONS: In all patients IL-2 and IL-4 concentration were in a range characteristic for healthy people. There was statistically important correlation between the severe clinical stage and high concentration of serum IL-6 (p<0.000319), IL-8 (p<0.000708), TNF-alfa (p<0.000018) and CRP (p< 0.001611) in patients with ALC. High concentration of serum IL-6, IL-8, TNF-alfa and CRP were correlated with poor prognosis (3 patients with ALC and the highest concentration died). High concentration of IL-6, IL-8, TNF-alfa and CRP were correlated with heavy clinical stage and poor prognosis so their evaluation can be helpful in the assessment of prognosis in patients with ALC and ALH.

Pathogenesis of hepatic encephalopathy.

Hepatic encephalopathy can be a serious complication of acute liver failure and chronic liver diseases, predominantly liver cirrhosis. Hyperammonemia plays the most important role in the pathogenesis of hepatic encephalopathy. The brain-blood barrier disturbances, changes in neurotransmission, neuroinflammation, oxidative stress, GABA-ergic or benzodiazepine pathway abnormalities, manganese neurotoxicity, brain energetic disturbances, and brain blood flow abnormalities are considered to be involved in the development of hepatic encephalopathy. The influence of small intestine bacterial overgrowth (SIBO) on the induction of minimal hepatic encephalopathy is recently emphasized. The aim of this paper is to present the current views on the pathogenesis of hepatic encephalopathy.

Biological therapy of inflammatory bowel disease.

Ulcerative colitis (UC), Crohn's disease (CD) and indeterminate colitis are defined as inflammatory bowel diseases (IBD). Those diseases involve disorders of numerous immunological mechanisms associated with cellular and humoral immune response. In CD cellular response is considered to be of crucial importance, and dominant cytokines include: tumor necrosis factor alpha (TNF-alpha), interferon gamma (INF-gamma) and interleukins 1beta (IL-1beta), IL-2, IL-6, IL-8, IL-12. In UC, increased expression of Th2 (responsible for humoral response) is observed. It is connected with increased production of interleukins: 4 (IL-4), IL-5, IL-6, IL-10 and TNF-alpha. Lack of balance between pro-inflammatory and anti-inflammatory cytokines is of vital importance in pathogenesis of IBD. Conventional therapy of CD and UC quite commonly fails to bring satisfactory results, therefore an interest in new therapeutic options, that is, biological therapy, gene therapy, hematopoietic stem cell transplantation, and leucapheresis, has aroused recently. Biological therapy is focused on different stages of the inflammatory process. The fundamentals of biological strategy involve neutralization of pro-inflammatory cytokines, use of anti-inflammatory cytokines and inhibition of neutrophil adhesion. Biological therapy is a promising option because it enables to withdraw corticosteroids and immunosuppressive agents or to reduce their dose. Moreover, it shortens the hospital stay, allows to avoid surgical procedures, extends the remission period and improves patients' quality of life. Currently, 2 agents, infliximab and adalimumab, are registered for the biological therapy of CD in Poland.