TITLE

Introduction and overview: recent advances in the immunotherapy of inflammatory bowel disease

AUTHOR(S)
Hibi, Toshifumi; Inoue, Nagamu; Ogata, Haruhiko; Naganuma, Makoto
PUB. DATE
March 2003
SOURCE
Journal of Gastroenterology;2003 Supplement 15, Vol. 38, p36
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Ulcerative colitis (UC) and Crohn's disease (CD) comprise a series of inflammatory bowel disease (IBD) resulting from chronic upregulation of the mucosal immune system. Although the pathogenesis of IBD remains elusive, it appears that there is chronic activation of the immune and inflammatory cascade in genetically susceptible individuals. Current disease management guidelines have therefore focused on the use of anti-inflammatory agents, aminosalicylates and corticosteroids. However, some patients are still refractory to these therapies. Recent advances in the understanding of the pathophysiological conditions of IBD have provided new immune system modulators as therapeutic tools. Cytapheresis has demonstrated effectiveness against UC and has practical use in Japan. Immunosuppressive agents including cyclosporin A and tacrolimus (FK506) have expanded the choice of medical therapies available for certain subgroups of patterns. Further more, biological therapies have begun to assume a prominent role. Studies with chimeric monoclonal anti-TNF-α antibody treatment of CD have been reported with dramatic success. Another antiinflammatory cytokine therapy includes anti-IL-6 receptor, anti-IL-12, or toxin-conjugated anti-IL-7 receptor. Given the diversity of proinflammatory products under its control, NF-κB may be viewed as a master switch in lymphocytes and macrophages, regulating inflammation and immunity. In the murine 2,4,6-trinitrobenzen sulfonic acid (TNBS) colitis model, an antisense oligonucleotide to NF-κB p65 ameliorated inflammation even after induction of colitis. Recently, a clinical pilot trial of this agent demonstrated promising results. Accumulating evidence suggests that luminal bacterial flora is a requisite and central factor in the development of IBD. Probiotic therapies such as a nonpathogenic Escherichia coli strain have been well tolerated, but larger clinical trials are needed. In addition, novel therapeutic strategies targeting adhesion molecules and costimulatory molecules, or enhancing tissue repair, are under investigation. Although some still need more confirmatory studies, these immune therapies will provide new insights into cell-based and gene-based treatment against IBD in the near future.
ACCESSION #
18317307

 

Related Articles

  • Cytokines in inflammatory bowel disease. Neurath, Markus F. // Nature Reviews Immunology;May2014, Vol. 14 Issue 5, p329 

    Cytokines have a crucial role in the pathogenesis of inflammatory bowel diseases (IBDs), such as Crohn's disease and ulcerative colitis, where they control multiple aspects of the inflammatory response. In particular, the imbalance between pro-inflammatory and anti-inflammatory cytokines that...

  • New pathophysiological insights and modern treatment of IBD. Engel, Matthias A.; Neurath, Markus F. // Journal of Gastroenterology;Jun2010, Vol. 45 Issue 6, p571 

    Inflammatory bowel disease (IBD), which comprises two main types, namely, Crohn’s disease and ulcerative colitis, affects approximately 3.6 million people in the USA and Europe, and an alarming rise in low-incidence areas, such as Asia, is currently being observed. In the last decade,...

  • Immunosuppressant Medications and Mortality in Inflammatory Bowel Disease. Lewis, James D.; Gelfand, Joel M.; Troxel, Andrea B.; Forde, Kimberly A.; Newcomb, Craig; Kim, Hopiy; Margolis, David J.; Strom, Brian L. // American Journal of Gastroenterology;Jun2008, Vol. 103 Issue 6, p1428 

    OBJECTIVE: This study examined whether treatment of Crohn's disease (CD) and ulcerative colitis (UC) with immunosuppressant medications was associated with an increased risk of death in the era prior to antitumor necrosis factor (TNF) therapies. DESIGN: This retrospective cohort study used data...

  • Insight into Crohn's disease pathomorphology. Mudter, Jonas; Neurath, Markus // Abdominal Imaging;Dec2012, Vol. 37 Issue 6, p921 

    Crohn's disease (CD) belongs together with ulcerative colitis to the two major forms of inflammatory bowel diseases (IBD). Although its etiology remains poorly understood, several genetic and immune factors and cells (especially T cells) have been shown to be involved in the pathogenesis of IBD....

  • Anti-inflammatory and immunomodulatory efficacy of indigenous probiotic Lactobacillus plantarum Lp91 in colitis mouse model. Duary, Raj; Bhausaheb, Mache; Batish, Virender; Grover, Sunita // Molecular Biology Reports;Apr2012, Vol. 39 Issue 4, p4765 

    Probiotics can affect the immune homeostasis by altering the gut microbial balance and enhancing the immune system of gut, thus benefits in Inflammatory Bowel Disease, including Crohn's disease and Ulcerative colitis. Relative gene expression of pro, anti-inflammatory cytokines and other...

  • Tolerance of Nonsteroidal Antiinflammatory Drugs in Patients With Inflammatory Bowel Disease. Bonner, Gregory F.; Walczak, Michelle; Kitchen, Laurel; Bayona, Manuel // American Journal of Gastroenterology;Aug2000, Vol. 95 Issue 8, p1946 

    OBJECTIVE: We sought to examine whether use of nonsteroidal antiinflammatory drugs (NSAIDs) in an outpatient inflammatory bowel disease (IBD) population is associated with an increased likelihood of active disease. METHODS: We reviewed records of initial outpatient visits of IBD patients to the...

  • Effects of Nonsteroidal Antiinflammatory Drugs on Inflammatory Bowel Disease: A Case-Control Study. Felder, Joseph B.; Korelitz, Burton I.; Rajapakse, Ramona; Schwarz, Samuel; Horatagis, Angelo P.; Gleim, Gilbert // American Journal of Gastroenterology;Aug2000, Vol. 95 Issue 8, p1949 

    OBJECTIVE: The aim of this study was to determine whether a relationship exists between the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and exacerbation or onset of inflammatory bowel disease (IBD). METHODS: Sixty consecutive IBD patients admitted to the hospital were carefully...

  • Are there any differences in the efficacy and safety of different formulations of oral 5-ASA used for induction and maintenance of remission in ulcerative colitis? Evidence from Cochrane reviews. Balzola, Federico; Cullen, Garret; Ho, Gwo-Tzer; Russell, Richard K. // Inflammatory Bowel Disease Monitor;2013, Vol. 14 Issue 1, p24 

    The article presents a study that reviews the difference between various formulations of 5-aminosalicylic acid in patients with ulcerative colitis. It describes the method of the study that observes 2925 ulcerative colitis patients using randomized controlled trials. It outlines the findings of...

  • Combined therapeutic approach: Inflammatory bowel diseases and peripheral or axial arthritis. Atzeni, Fabiola; Ardizzone, Sandro; Bertani, Luca; Antivalle, Marco; Batticciotto, Alberto; Sarzi-Puttini, Piercarlo; Eliakim, Abraham R. // World Journal of Gastroenterology;5/28/2009, Vol. 15 Issue 20, p2469 

    Inflammatory bowel diseases (IBDs), particularly Crohn's disease (CD) and ulcerative colitis (UC), are associated with a variety of extra-intestinal manifestations (EIMs). About 36% of IBD patients have at least one EIM, which most frequently affect the joints, skin, eyes and the biliary tract....

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics