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Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis
Published on: October 14, 2025
Evolving inflammatory bowel disease treatment paradigms: top-down versus step-up
Shane M Devlin1, Remo Panaccione
1Division of Gastroenterology, Inflammatory Bowel Disease Clinic, Department of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, Alberta, Canada T2N 4N1.
Gastroenterology Clinics of North America
|November 17, 2009
Summary
Crohn disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD) with overlapping features. Current research supports earlier use of immunosuppressive and biologic agents, especially for CD, aiming for mucosal healing.
Area of Science:
- Gastroenterology and Immunology
- Molecular and Genetic Medicine
Background:
- Crohn disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) with variable clinical presentations.
- Genetic and immunologic insights suggest CD and UC may exist on a disease continuum.
- Existing classification systems for CD and IBD require refinement based on new data.
Purpose of the Study:
- To review current therapeutic strategies for CD and UC.
- To explore evolving paradigms in IBD management.
- To provide evidence supporting a 'top-down' therapeutic approach for CD.
Main Methods:
- Literature review of current therapeutic approaches for CD and UC.
- Analysis of evidence supporting new treatment strategies.
- Focus on mucosal healing as a treatment endpoint and early intervention with advanced therapies.
Main Results:
- IBD classification is advancing based on clinical, molecular, and serologic profiles.
- Personalized treatment strategies are needed due to disease heterogeneity.
- Evidence supports earlier use of immunosuppressive and biologic agents, particularly in CD.
Conclusions:
- A shift towards earlier and more aggressive treatment, including biologic agents, is warranted for IBD.
- Mucosal healing should be a primary therapeutic endpoint in managing CD and UC.
- Refined classification and targeted therapies will improve patient outcomes in IBD.
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