Immunotherapy in inflammatory bowel disease: Novel and emerging treatments
Inflammatory bowel disease (IBD) is a chronic disabling inflammatory process that affects young individuals, with growing incidence. The etiopathogenesis of IBD remains poorly understood. A combination of genetic and environmental factors triggers an inadequate immune response against the commensal...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2018-11-01
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| Series: | Human Vaccines & Immunotherapeutics |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/21645515.2018.1461297 |
| _version_ | 1797677489986732032 |
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| author | Ignacio Catalan-Serra Øystein Brenna |
| author_facet | Ignacio Catalan-Serra Øystein Brenna |
| author_sort | Ignacio Catalan-Serra |
| collection | DOAJ |
| description | Inflammatory bowel disease (IBD) is a chronic disabling inflammatory process that affects young individuals, with growing incidence. The etiopathogenesis of IBD remains poorly understood. A combination of genetic and environmental factors triggers an inadequate immune response against the commensal intestinal flora in IBD patients. Thus, a better understanding of the immunological mechanisms involved in IBD pathogenesis is central to the development of new therapeutic options. Current pharmacological treatments used in clinical practice like thiopurines or anti-TNF are effective but can produce significant side effects and their efficacy may diminish over time. In fact, up to one third of the patients do not have a satisfactory response to these therapies. Consequently, the search for new therapeutic strategies targeting alternative immunological pathways has intensified. Several new oral and parenteral substances are in the pipeline for IBD. In this review we discuss novel therapies targeting alternative pro-inflammatory pathways like IL-12/23 axis, IL-6 pathway or Janus Kinase inhibitors; as well as others modulating anti-inflammatory signalling pathways like transforming growth factor-β1 (TGF-β1). We also highlight new emerging therapies targeting the adhesion and migration of leukocytes into the inflamed intestinal mucosa by blocking selectively different subunits of α4β7 integrins or binding alternative adhesion molecules like MAdCAM-1. Drugs reducing the circulating lymphocytes by sequestering them in secondary lymphoid organs (sphingosine-1-phosphate (S1P) receptor modulators) are also discussed. Finally, the latest advances in cell therapies using mesenchymal stem cells or engineered T regs are reviewed. In addition, we provide an update on the current status in clinical trials of these new immune-regulating therapies that open a new era in the treatment of IBD. |
| first_indexed | 2024-03-11T22:45:53Z |
| format | Article |
| id | doaj.art-9abd9018b8ae4e9d8b99a2a9c1e965a2 |
| institution | Directory Open Access Journal |
| issn | 2164-5515 2164-554X |
| language | English |
| last_indexed | 2024-03-11T22:45:53Z |
| publishDate | 2018-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj.art-9abd9018b8ae4e9d8b99a2a9c1e965a22023-09-22T08:38:21ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2018-11-0114112597261110.1080/21645515.2018.14612971461297Immunotherapy in inflammatory bowel disease: Novel and emerging treatmentsIgnacio Catalan-Serra0Øystein Brenna1Gastroenterology, Levanger Hospital, Nord-Trøndelag Hospital TrustGastroenterology, Levanger Hospital, Nord-Trøndelag Hospital TrustInflammatory bowel disease (IBD) is a chronic disabling inflammatory process that affects young individuals, with growing incidence. The etiopathogenesis of IBD remains poorly understood. A combination of genetic and environmental factors triggers an inadequate immune response against the commensal intestinal flora in IBD patients. Thus, a better understanding of the immunological mechanisms involved in IBD pathogenesis is central to the development of new therapeutic options. Current pharmacological treatments used in clinical practice like thiopurines or anti-TNF are effective but can produce significant side effects and their efficacy may diminish over time. In fact, up to one third of the patients do not have a satisfactory response to these therapies. Consequently, the search for new therapeutic strategies targeting alternative immunological pathways has intensified. Several new oral and parenteral substances are in the pipeline for IBD. In this review we discuss novel therapies targeting alternative pro-inflammatory pathways like IL-12/23 axis, IL-6 pathway or Janus Kinase inhibitors; as well as others modulating anti-inflammatory signalling pathways like transforming growth factor-β1 (TGF-β1). We also highlight new emerging therapies targeting the adhesion and migration of leukocytes into the inflamed intestinal mucosa by blocking selectively different subunits of α4β7 integrins or binding alternative adhesion molecules like MAdCAM-1. Drugs reducing the circulating lymphocytes by sequestering them in secondary lymphoid organs (sphingosine-1-phosphate (S1P) receptor modulators) are also discussed. Finally, the latest advances in cell therapies using mesenchymal stem cells or engineered T regs are reviewed. In addition, we provide an update on the current status in clinical trials of these new immune-regulating therapies that open a new era in the treatment of IBD.http://dx.doi.org/10.1080/21645515.2018.1461297inflammatory bowel diseasetherapycrohn's diseaseulcerative colitisjanus kinasesadhesion moleculescell therapy |
| spellingShingle | Ignacio Catalan-Serra Øystein Brenna Immunotherapy in inflammatory bowel disease: Novel and emerging treatments Human Vaccines & Immunotherapeutics inflammatory bowel disease therapy crohn's disease ulcerative colitis janus kinases adhesion molecules cell therapy |
| title | Immunotherapy in inflammatory bowel disease: Novel and emerging treatments |
| title_full | Immunotherapy in inflammatory bowel disease: Novel and emerging treatments |
| title_fullStr | Immunotherapy in inflammatory bowel disease: Novel and emerging treatments |
| title_full_unstemmed | Immunotherapy in inflammatory bowel disease: Novel and emerging treatments |
| title_short | Immunotherapy in inflammatory bowel disease: Novel and emerging treatments |
| title_sort | immunotherapy in inflammatory bowel disease novel and emerging treatments |
| topic | inflammatory bowel disease therapy crohn's disease ulcerative colitis janus kinases adhesion molecules cell therapy |
| url | http://dx.doi.org/10.1080/21645515.2018.1461297 |
| work_keys_str_mv | AT ignaciocatalanserra immunotherapyininflammatoryboweldiseasenovelandemergingtreatments AT øysteinbrenna immunotherapyininflammatoryboweldiseasenovelandemergingtreatments |