Cytokines in inflammatory bowel diseases - Update 2020

Area of Science:

• Immunology
• Gastroenterology
• Pharmacology

Background:

• Inflammatory Bowel Diseases (IBD), including Crohn's Disease and Ulcerative Colitis, represent a significant global health challenge.
• Cytokine-targeted therapies have emerged as crucial treatments for IBD over the past two decades.
• Recent research highlights the critical roles of myeloid and lymphoid cells and their cytokine interactions in IBD pathogenesis.

Purpose of the Study:

• To review the evolving understanding of the mucosal cytokine network in IBD.
• To contextualize the cytokine network within the pathogenesis of IBD, focusing on recent advancements.
• To present a modular framework for comprehending cytokine interplay in IBD.

Main Methods:

• Literature review focusing on publications since 2014.
• Analysis of the shift in conceptual frameworks regarding immune cell interactions in IBD.
• Evaluation of the impact of cytokine-directed therapies on IBD treatment.

Main Results:

• The understanding of IBD pathogenesis has evolved from a Th1/Th2 dichotomy to recognizing the effector/regulatory T cell balance.
• The crucial role of myeloid cells in instructing lymphocytes via cytokines like IL-12 and IL-23 is increasingly acknowledged.
• Anti-cytokine therapies, such as ustekinumab (anti-IL-12p40), have significantly improved patient care, with anti-IL-23p19 agents showing great promise.

Conclusions:

• The cytokine network is central to IBD pathogenesis.
• Targeting specific cytokines, like IL-12 and IL-23, offers effective therapeutic strategies for IBD.
• Continued research into cytokine-mediated pathways is essential for advancing IBD treatment.