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Drugs for Treatment of Ulcerative Colitis in IBD

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Peptic Ulcer Disease II: Pathophysiology01:28

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Peptic Ulcer Disease (PUD) is characterized by the development of ulcers in the stomach or duodenal mucosa. Its pathophysiology is complex, involving a balance between damaging and protective elements.
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Peptic Ulcer Disease I: Introduction01:30

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Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
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Peptic Ulcer Disease IV: Management01:26

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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
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Can IL-23 be a good target for ulcerative colitis?

Mariangela Allocca1, Federica Furfaro2, Gionata Fiorino1

  • 1IBD Centre, Humanitas Clinical and Research Centre, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.

Best Practice & Research. Clinical Gastroenterology
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Summary

Many ulcerative colitis patients lack effective treatments. This review explores targeting interleukin-23 (IL-23) and T helper 17 (Th17) cells, offering potential new therapies for this chronic condition.

Keywords:
Crohn's diseaseIL-23Inflammatory bowel diseaseMonoclonal antibody anti-IL23Th17 cell pathway cytokinesUlcerative colitis

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Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • A significant portion of ulcerative colitis (UC) patients exhibit non-response or loss of response to current therapies like anti-tumor necrosis factor (TNF) agents and vedolizumab.
  • The need for novel therapeutic strategies and drugs to manage chronic ulcerative colitis is ongoing.
  • Elevated levels of interleukin-23 (IL-23) and T helper 17 (Th17) cell cytokines are observed in the intestinal mucosa, plasma, and serum of patients with inflammatory bowel disease (IBD).

Purpose of the Study:

  • To review existing data on the IL-23 and Th17 cell pathways in UC.
  • To determine the potential role of IL-23 as a therapeutic target for UC treatment.

Main Methods:

  • Literature review of studies investigating IL-23 and Th17 pathways in UC.
  • Analysis of data on the efficacy of IL-23 blockade in experimental colitis.
  • Examination of ustekinumab's safety and efficacy in Crohn's disease.

Main Results:

  • IL-23-blocking strategies have demonstrated a reduction in inflammation severity in experimental colitis models.
  • Ustekinumab, an antibody targeting the p40 subunit of IL-12 and IL-23, has shown promising efficacy and safety in Crohn's disease patients.

Conclusions:

  • The IL-23 and Th17 cell pathways are implicated in the pathogenesis of UC.
  • Targeting IL-23 presents a promising therapeutic avenue for managing ulcerative colitis.