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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.
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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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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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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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Updated: Apr 20, 2026

Induction of Ocular Surface Inflammation and Collection of Involved Tissues
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Selective IL-23 Inhibition in Conventional Treatment-Refractory Pyoderma Gangrenosum: A Multicenter, Retrospective

Luca Bettolini1,2, Carlo Alberto Maronese1,3, Federica Derlino1

  • 1Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.

International Journal of Dermatology
|April 18, 2026
PubMed
Summary
This summary is machine-generated.

Selective IL-23 inhibitors effectively treat refractory pyoderma gangrenosum (PG), improving ulcers and reducing steroid dependence. This approach offers a well-tolerated option for patients with difficult-to-manage PG.

Keywords:
IL‐23 inhibitorsguselkumabneutrophilic dermatosespyoderma gangrenosumrisankizumabtildrakizumab

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Area of Science:

  • Dermatology
  • Immunology
  • Pharmacology

Background:

  • Pyoderma gangrenosum (PG) management is challenging due to conventional therapy limitations like incomplete response, relapses, and toxicity.
  • The interleukin (IL)-23/IL-17 axis is implicated in PG pathogenesis, making IL-23 inhibition a promising therapeutic strategy.
  • This study investigates selective IL-23 inhibitors for treatment-refractory PG.

Purpose of the Study:

  • To assess the effectiveness and safety of selective IL-23 inhibitors in patients with refractory PG.
  • To evaluate the steroid-sparing potential of IL-23 inhibitors.
  • To identify predictors of treatment response to IL-23 inhibitors.

Main Methods:

  • A multicenter retrospective study involving 18 adult patients with refractory PG treated with guselkumab, risankizumab, or tildrakizumab.
  • Clinical outcomes including ulcer area, lesion count, depth, wound bed characteristics, and pain were assessed at multiple follow-up points.
  • Longitudinal data analysis utilized non-parametric tests for repeated measures.

Main Results:

  • Selective IL-23 inhibition led to significant reductions in ulcer area, number of active ulcers, and ulcer depth from 3 months onward.
  • Improvements were observed in border/perilesional inflammation and wound bed characteristics, alongside significant pain reduction.
  • A notable steroid-sparing effect was achieved, with progressive reduction in corticosteroid dosage during follow-up. Guselkumab and risankizumab demonstrated comparable efficacy.

Conclusions:

  • Selective IL-23 inhibition is a well-tolerated and effective treatment for refractory PG, offering significant clinical improvement.
  • These agents provide a meaningful steroid-sparing effect, reducing reliance on conventional therapies.
  • Further controlled studies are warranted to establish the role of IL-23 inhibitors in PG treatment algorithms.