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Interfering with leukocyte trafficking in Crohn's disease
Sujata Biswas1, Robert V Bryant2, Simon Travis1
1Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
Best Practice & Research. Clinical Gastroenterology
|July 23, 2019
Summary
New drugs targeting leukocyte trafficking offer improved treatments for inflammatory bowel disease (IBD). Vedolizumab provides gut-specific immunosuppression, enhancing safety and efficacy for Crohn
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Inflammatory bowel disease (IBD) treatment has advanced with the discovery of gut-specific leukocytes.
- Modulating leukocyte function targets lymphocyte-endothelial cell interactions via integrins and cellular adhesion molecules.
- Safety, efficacy, and sustained effects are critical for this drug class, despite risks like natalizumab-associated infections.
Purpose of the Study:
- To review the safety, efficacy, and practice points of licensed drugs for IBD.
- To discuss emerging therapies targeting leukocyte trafficking for IBD.
- To present initial results from ongoing therapeutic trials in IBD.
Main Methods:
- Review of licensed drugs and ongoing therapeutic trials for IBD.
- Analysis of drug targets including ICAM-1, MAdCAM-1, α4 receptors, CCR9, and sphingosine 1-phosphate receptors.
- Discussion of vedolizumab's gut-specific immunosuppression for Crohn's disease.
Main Results:
- Vedolizumab offers gut-specific immunosuppression for Crohn's disease.
- Various targets for leukocyte trafficking modulators are under investigation.
- Oral and subcutaneous therapies are in development, with initial trial results showing promise.
Conclusions:
- Targeting leukocyte trafficking represents a significant advancement in IBD treatment.
- Vedolizumab provides a safer, gut-specific option compared to broader immunosuppressants.
- Ongoing research into novel targets and delivery methods promises further therapeutic improvements for IBD.
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