New targets for mucosal healing and therapy in inflammatory bowel diseases

• Published in: Mucosal immunology Vol. 7; no. 1; pp. 6 - 19
• Main Author: Neurath, M F
• Format: Journal Article
• Language: English
• Published: United States Nature Publishing Group 01.01.2014
• Subjects: Adaptive Immunity - drug effects; Animals; Antibodies, Monoclonal - therapeutic use; Cell Adhesion - drug effects; Cytokines - antagonists & inhibitors; Cytokines - metabolism; Humans; Immunity, Innate; Immunologic Factors - therapeutic use; Immunosuppressive Agents - therapeutic use; Inflammation Mediators - antagonists & inhibitors; Inflammation Mediators - metabolism; Inflammatory Bowel Diseases - immunology; Inflammatory Bowel Diseases - metabolism; Inflammatory Bowel Diseases - microbiology; Inflammatory Bowel Diseases - therapy; Intestinal Mucosa - immunology; Intestinal Mucosa - metabolism; Intestinal Mucosa - microbiology; Intestinal Mucosa - pathology; Microbiota; Signal Transduction - drug effects; T-Lymphocyte Subsets - immunology; T-Lymphocyte Subsets - metabolism; T-Lymphocytes, Regulatory - immunology; T-Lymphocytes, Regulatory - metabolism; Tumor Necrosis Factor Inhibitors; Tumor Necrosis Factors - metabolism; Wound Healing - immunology
• ISSN: 1933-0219; 1935-3456
• DOI: 10.1038/mi.2013.73

Healing of the inflamed mucosa (mucosal healing) is an emerging new goal for therapy and predicts clinical remission and resection-free survival in inflammatory bowel diseases (IBDs). The era of antitumor necrosis factor (TNF) antibody therapy was a remarkable progress in IBD therapy and anti-TNF agents led to mucosal healing in a subgroup of IBD patients; however, many patients do not respond to anti-TNF treatment highlighting the relevance of finding new targets for therapy of IBD. In particular, current studies are addressing the role of other anticytokine agents including antibodies against interleukin (IL)-6R, IL-13, and IL-12/IL-23 as well as new anti-inflammatory concepts (regulatory T cell therapy, Smad7 antisense, Jak inhibition, Toll-like receptor 9 stimulation, worm eggs). In addition, blockade of T-cell homing via the integrins α4β7 and the addressin mucosal vascular addressin cell adhesion molecule 1 (MAdCAM-1) emerges as a promising new approach for IBD therapy. Here, new approaches for achieving mucosal healing are discussed as well as their implications for future therapy of IBD.