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Induction of Intestinal Inflammation by Adoptive Transfer of CBir1 TCR Transgenic CD4+ T Cells to Immunodeficient Mice
Published on: December 16, 2021
Refractory Inflammatory Bowel Disease
Karl H. Kim1, Gary R. Lichtenstein
1Division of Gastroenterology, Department of Medicine, University of Pennsylvania School of Medicine, 3400 Spruce Street, 3rd Floor Ravdin Building, Philadelphia, PA 19104-4283, USA. grl@uphs.upenn.edu
Abstract:
Therapeutic options for refractory colonic inflammation in patients with ulcerative colitis or Crohn's disease have recently been expanded with the introduction of biologic therapies. Intravenous corticosteroids and cyclosporine A remain the standard therapies for severe ulcerative colitis. Monoclonal antibodies directed at tumor necrosis factor-a have proven to be exceptionally efficacious in patients with severe or refractory Crohn's disease. Immunomodulatory therapy with azathioprine, 6-mercaptopurine, or methotrexate has demonstrated efficacy for maintenance of remission in patients with refractory ulcerative colitis or Crohn's disease. The use of experimental biologic agents may be considered for those patients who fail to respond to or remain dependent on corticosteroids. Surgical intervention still remains for patients with severe colitis who fail to respond to medical therapy or develop life-threatening complications such as perforation or toxic megacolon.
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