Research progress in molecular targeted therapy for inflammatory bowel disease

Area of Science:

• Gastroenterology and immunology, focusing on Inflammatory Bowel Disease (IBD) pathogenesis and therapeutic interventions.

Background:

• Inflammatory Bowel Disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), shows rising prevalence in China, driven by urbanization and lifestyle shifts.
• Conventional IBD treatments have limitations in efficacy and safety for moderate-to-severe cases, necessitating advanced precision-based therapies.
• Pathogenesis involves dysregulated inflammatory pathways like NF-κB, IL-23/Th17, and TGF-β, targeted by novel molecular therapies.

Purpose of the Study:

• To review recent advances in molecular targeted therapy for IBD, clarifying mechanisms and evaluating efficacy and safety of emerging agents.
• To inform clinical decision-making and guide future research directions in IBD treatment.

Main Methods:

• Comprehensive literature search (2014-2025) in PubMed, Embase, and Cochrane Library.
• Keywords included 'inflammatory bowel disease,' 'molecular targeted therapy,' 'TNF inhibitors,' 'JAK inhibitors,' and 'biomarkers.'
• Analysis of over 500 clinical trials, meta-analyses, and mechanistic studies.

Main Results:

• Molecular targeted therapies, including TNF-α inhibitors, integrin antagonists, and JAK inhibitors, demonstrate significant improvements in IBD remission rates.
• Personalized treatment selection is supported by biomarkers like miR-21 and transcriptomic signatures.
• Therapeutic strategies are evolving from single-target to multi-pathway modulation, enhancing clinical management.

Conclusions:

• Molecular targeted therapy represents a transformative approach to IBD management, offering more precise and effective options than traditional treatments.
• Challenges remain, including primary non-response, secondary loss of response, and safety concerns (e.g., infections, cardiovascular events).
• Further research is crucial for refining therapeutic sequencing, integrating biomarkers, and optimizing the risk-benefit profile of novel IBD agents.