Current, experimental, and future treatments in inflammatory bowel disease: a clinical review

TY - JOUR

T1 - Current, experimental, and future treatments in inflammatory bowel disease

T2 - a clinical review

AU - Hvas, Christian L

AU - Bendix, Mia

AU - Dige, Anders

AU - Dahlerup, Jens F

AU - Agnholt, Jørgen

PY - 2018

Y1 - 2018

N2 - Inflammatory bowel diseases (IBDs) may result from dysregulated mucosal immune responses directed toward the resident intestinal microbiota. This review describes the hallmark immunobiology of Crohn's disease and ulcerative colitis as well as therapeutic targets and mechanisms of action for current, experimental, and future treatments in IBD. Conventional therapies include 5-aminosalicylic acid, glucocorticosteroids, thiopurines, and methotrexate. Since 1997, monoclonal antibodies have gained widespread use. These consist of antibodies directed against pro-inflammatory cytokines such as tumor necrosis factor α, interleukin (IL)-12, and IL-23, or anti-homing antibodies directed against α4β7 integrin. Emerging oral therapies include modulators of intracellular signal transduction such as Janus kinase inhibitors. Vitamin D may help to regulate innate and adaptive immune responses. Modulation of the intestinal microbiota, using live microorganisms (probiotics), substrates for the colonic microbiota (prebiotics), or fecal microbiota transplantation (FMT), is in development. Dietary supplements are in widespread use, but providing evidence for their benefit is challenging. Stem cell treatment and nervous stimulation are promising future treatments.

AB - Inflammatory bowel diseases (IBDs) may result from dysregulated mucosal immune responses directed toward the resident intestinal microbiota. This review describes the hallmark immunobiology of Crohn's disease and ulcerative colitis as well as therapeutic targets and mechanisms of action for current, experimental, and future treatments in IBD. Conventional therapies include 5-aminosalicylic acid, glucocorticosteroids, thiopurines, and methotrexate. Since 1997, monoclonal antibodies have gained widespread use. These consist of antibodies directed against pro-inflammatory cytokines such as tumor necrosis factor α, interleukin (IL)-12, and IL-23, or anti-homing antibodies directed against α4β7 integrin. Emerging oral therapies include modulators of intracellular signal transduction such as Janus kinase inhibitors. Vitamin D may help to regulate innate and adaptive immune responses. Modulation of the intestinal microbiota, using live microorganisms (probiotics), substrates for the colonic microbiota (prebiotics), or fecal microbiota transplantation (FMT), is in development. Dietary supplements are in widespread use, but providing evidence for their benefit is challenging. Stem cell treatment and nervous stimulation are promising future treatments.

KW - Crohn’s disease

KW - Inflammatory bowel disease

KW - antibodies

KW - fecal microbiota transplantation

KW - monoclonal

KW - ulcerative colitis

UR - http://www.scopus.com/inward/record.url?scp=85063090960&partnerID=8YFLogxK

U2 - 10.1080/08923973.2018.1469144

DO - 10.1080/08923973.2018.1469144

M3 - Journal article

C2 - 29745777

SN - 0892-3973

VL - 40

SP - 446

EP - 460

JO - Immunopharmacology and Immunotoxicology

JF - Immunopharmacology and Immunotoxicology

IS - 6

ER -