Classical and recent advances in the treatment of inflammatory bowel diseases

Abstract

Crohn's disease (CD) and ulcerative colitis (UC) are intestinal disorders that comprise the inflammatory bowel diseases (IBD). These disorders have a significant effect on the quality of life of affected patients and the increasing number of IBD cases worldwide is a growing concern. Because of the overall burden of IBD and its multifactorial etiology, efforts have been made to improve the medical management of these inflammatory conditions. The classical therapeutic strategies aim to control the exacerbated host immune response with aminosalicylates, antibiotics, corticosteroids, thiopurines, methotrexate and anti-tumor necrosis factor (TNF) biological agents. Although successful in the treatment of several CD or UC conditions, these drugs have limited effectiveness, and variable responses may culminate in unpredictable outcomes. The ideal therapy should reduce inflammation without inducing immunosuppression, and remains a challenge to health care personnel. Recently, a number of additional approaches to IBD therapy, such as new target molecules for biological agents and cellular therapy, have shown promising results. A deeper understanding of IBD pathogenesis and the availability of novel therapies are needed to improve therapeutic success. This review describes the overall key features of therapies currently employed in clinical practice as well as novel and future alternative IBD treatment methods.

The Potency of Indonesia’s Pomegranate Peel Ethanol Extract (Punica Granatum Linn.) as Anti-Inflammatory Agent in Mice Colon Induced by Dextran Sodium Sulfate: Focus on Cyclooxygenase-2 and Inos Expressions

“…The current treatment is still conventional depends on the extent of the disease. Corticosteroids and 5-ASA such as mesalazine, sulfasalazine, olsalazine, and balsalazide as antiinflammatory agents are first-line therapies [12,13]. The administration of 5-ASA drugs has uncomfortable side effects such as nausea, vomiting, diarrhea, and myalgia [13].…”

“…Corticosteroids and 5-ASA such as mesalazine, sulfasalazine, olsalazine, and balsalazide as antiinflammatory agents are first-line therapies [12,13]. The administration of 5-ASA drugs has uncomfortable side effects such as nausea, vomiting, diarrhea, and myalgia [13]. Furthermore, 5-ASA as a first-line in some patients may be poorly responsive to this therapy, so the use of this drug still controversial.…”

Pharmacological- and non-pharmacological therapeutic approaches in inflammatory bowel disease in adults

“…Enteric bacteria, viruses or fungi may induce IBD, thus fecal microbiota transplantation or fecal bacterio therapy (from a healthy individual) is also a therapeutic option in IBD [179] . Autologous hematopoietic stem cell transplantation (aHSCT) has been used as a treatment for severe, active and therapyrefractory autoimmune diseases for more than 13 years [180,181] . In 2012 the EBMT published guidelines for the selection of patients with autoimmune diseases [182] .…”

The relationship between the immune system and oral manifestations of inflammatory bowel disease: a review

“…In the acute stages of the disease, corticosteroids are used. However, if they are used on a daily basis or for a long time, even in small doses, primarily systemic, they can cause numerous adverse effects [89]. The other therapeutic approach, top-down, is increasingly being used for the patients with considerable risk factors for severe inflammation or unfavorable course of the disease.…”