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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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T Cell Types and Functions

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When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Partial enteral nutrition combined with an exclusion diet promotes a healthy gut microbiome in patients with mild to moderately active ulcerative colitis: a quasi-experimental study.

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Targeting IL-23 for IBD: Rationale and Progress to Date.

Sudheer K Vuyyuru1,2, Lisa M Shackelton2, Jurij Hanzel2,3

  • 1Department of Medicine, Division of Gastroenterology, Western University, London, ON, Canada.

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Selective IL-23p19 antagonists show promise for inflammatory bowel disease (IBD). These targeted therapies offer improved outcomes for Crohn's disease and ulcerative colitis patients, representing a new frontier in IBD treatment.

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Area of Science:

  • Gastroenterology and Immunology
  • Molecular Medicine

Background:

  • Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, involves complex immune-mediated processes.
  • Early diagnosis and management are crucial to prevent severe complications and hospitalizations in IBD patients.

Purpose of the Study:

  • To review the mechanisms of action of IL-23p19 antagonists.
  • To summarize clinical trial evidence on the efficacy and safety of IL-23p19 antagonists for IBD treatment.

Main Methods:

  • Review of scientific literature and clinical trial data.
  • Analysis of therapeutic strategies targeting the IL-23/Th-17 axis in IBD.

Main Results:

  • IL-12/23p40 antagonists like ustekinumab are approved for moderate-to-severe Crohn's disease and ulcerative colitis.
  • Selective IL-23p19 antagonists have demonstrated improved outcomes in psoriasis and are under investigation for IBD.
  • Risankizumab, an IL-23p19 antagonist, is now approved for moderate-to-severe Crohn's disease.

Conclusions:

  • IL-23p19 antagonists represent a significant advancement in targeted therapy for IBD.
  • These agents offer a more selective approach compared to broader IL-12/23 inhibitors, with promising efficacy and safety profiles.
  • Further research and clinical application of IL-23p19 antagonists are expected to refine IBD management.