Gut-directed therapeutics in inflammatory bowel disease

Area of Science:

• Gastroenterology
• Immunology
• Pharmacology

Background:

• Tissue-directed therapies (TDTs) aim to enhance drug tolerance, safety, and efficacy.
• Inflammatory bowel disease (IBD) management is evolving with targeted treatment strategies.

Purpose of the Study:

• To provide a framework for understanding intestinal TDT.
• To review the current landscape of TDT in IBD treatment.

Main Methods:

• Review of existing literature on TDTs for IBD.
• Analysis of novel therapeutic agents and delivery systems.

Main Results:

• Vedolizumab, an anti-α4β7 integrin mAb, demonstrated the potential of TDT in IBD.
• Development of other mAbs (e.g., abrilumab, etrolizumab), oral small molecules (MORF-057), JAK inhibitors, and microbiome-based therapies.
• Innovative drug delivery systems including engineered yeast, hydrogels, nanoparticles, and gene therapy are emerging.

Conclusions:

• Gut-targeted therapies encompass modified traditional drugs, microbiome-based treatments, and advanced delivery systems.
• These therapies can be used as monotherapy or in combination.
• Future research should prioritize established modalities alongside microbiome and novel delivery approaches.