New therapeutic approaches in inflammatory bowel disease

1997 ◽  
Vol 50 (2) ◽  
pp. S15-S18
Author(s):  
H Hodgson
Author(s):  
Dikhnah Alshehri ◽  
Omar Saadah ◽  
Mahmoud Mosli ◽  
Sherif Edris ◽  
Rashad Alhindi ◽  
...  

There is a growing body of evidence reinforcing the unique connections between the host microbiome, health and diseases. Due to the extreme importance of the symbiotic relationship between the intestinal microbiome and the host, it is not surprising that any alteration in the gut microbiota would result in various diseases, including inflammatory bowel disease (IBD), Crohn’s disease (CD) and ulcerative colitis (UC). IBD is a chronic, relapsing-remitting condition that is associated with significant morbidity, mortality, compromised quality of life and costly medical care. Dysbiosis is believed to exacerbate the progression of IBD. One of the currently used treatments for IBD are anti-tumor necrosis factor (TNF) drugs, representing a biologic therapy that is reported to have an impact on the gut microbiota composition. The efficacy of anti-TNF agents is hindered by the possibility of non-response, which occurs in 10-20% of treated patients, and secondary loss of response, which occurs in up to 30% of treated patients. This underscores the need for novel therapies and studies that evaluate the role of the gut microbiota in these conditions. The success of any therapeutic strategy for IBD depends on our understanding of the interactions that occur between the gut microbiota and the host. In this review, the health and disease IBD-associated microbiota patterns will be discussed, in addition to the effect of currently used therapies for IBD on the gut microbiota composition, as well as new therapeutic approaches that can be used to overcome the current treatment constraints.


1989 ◽  
Vol 3 (2) ◽  
pp. 82-84 ◽  
Author(s):  
Ulrich Klotz

Strong evidence has been accumulating that mesalazine (5- aminosalicylic acid, 5-ASA) represents the therapeutic moiety of the standard drug sulphasalazine. Since the active metabolite avoids the toxic potential of sulphapyridine, this perception has initiated new therapeutic approaches, for example, two 5-ASA molecules have been coupled to form another prodrug (olsalazine) which again depends on a proper cleavage of the azobond by bacteria in the colon A more direct way has been applied successfully by administering 5-ASA itself in special galenic formulation (suppositories, enemas, controlled release preparations) to provide enough active material at the proposed sites of action in the terminal ileum and/or colon. One major advantage of all 5-ASA compounds, compared to sulphasalazine, is their 10-fold lower potential (incidence) for inducing allergic reactions or causing intolerance. Aside from rare hypersensitivity reactions, 5-ASA can cause nausea. vomiting, headache and gastrointestinal disturbances in 1 to 5% of patients. However, the new azocompound olsalazine induced diarrhea or loose stool in at least 10 to 15% of the treated patients which might limit its use in inflammatory bowel disease (IBD). In conclusion, the ‘old’ metabolite 5-ASA, in a ‘new’ design, offers an effective and very safe choice for the treatment of IBD.


2013 ◽  
Vol 32 (6) ◽  
pp. 904-910 ◽  
Author(s):  
Sara Massironi ◽  
Roberta Elisa Rossi ◽  
Federica Alessandra Cavalcoli ◽  
Serena Della Valle ◽  
Mirella Fraquelli ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Rosaely Casalegno Garduño ◽  
Jan Däbritz

CD8+ T cells are involved in the pathogenesis of inflammatory bowel disease (IBD), a complex multifactorial chronic disease. Here, we present an overview of the current research with the controversial findings of CD8+ T cell subsets and discuss some possible perspectives on their therapeutic value in IBD. Studies on the role of CD8+ T cells in IBD have contradictory outcomes, which might be related to the heterogeneity of the cells. Recent data suggest that cytotoxic CD8+ T cells (Tc1) and interleukin (IL) 17-producing CD8+ (Tc17) cells contribute to the pathogenesis of IBD. Moreover, subsets of regulatory CD8+ T cells are abundant at sites of inflammation and can exhibit pro-inflammatory features. Some subsets of tissue resident memory CD8+ T cells (Trm) might be immunosuppressant, whereas others might be pro-inflammatory. Lastly, exhausted T cells might indicate a positive outcome for patients. The function and plasticity of different subsets of CD8+ T cells in health and IBD remain to be further investigated in a challenging field due to the limited availability of mucosal samples and adequate controls.


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