Current, New and Future Therapeutic Targets in Inflammatory Bowel Disease: A Systematic Review

Abstract

<jats:sec> <jats:title /> <jats:p>Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic relapsing conditions resulting from immune system activity in a genetically predisposed individual. IBD is based on progressive damage to the inflamed gut tissue. As its pathogenesis remains unknown, recent accumulating data have demonstrated that IBD is a complex and multi-factorial disorder correlated with host luminal factors, which lead to an imbalance between pro- and anti-inflammatory signaling. The growing understanding of the molecular mechanisms responsible for IBD has suggested a wide range of potential therapeutic targets to treat this condition. Some patients do not have a satisfactory response to current therapeutic medications such as antitumor necrosis factor (TNF) agents, or their response decreases over time. As a result, IBD therapeutics have been changed recently, with several new agents being evaluated. The identification of various inflammatory cascades has led to forming the idea to have novel medications developed. Medications targeting Janus kinases (JAK), leukocyte trafficking Interleukin (IL) 12/23, and Sphingosine 1 phosphate (S1P) are among these newly developed medications and highlight the role of microbial-host interaction in inflammation as a safe promising strategy. This systematic review aims to summarize different molecular targeting therapeutics, the most potent candidates for IBD treatment in recent studies.</jats:p> </jats:sec>

Effect of fecal microbiota transplantation on the TGF-β1/Smad signaling pathway in rats with TNBS-induced colitis

“…In recent years, the therapeutic strategies for IBD have shifted away from general immunosuppressive treatment towards pathway-based approaches (16). These specific pathway-based drugs, such as anti-TNF, IL-12, and IL-23, Janus kinase inhibitors, and antisense oligonucleotides against inhibitors of the immunosuppressive cytokine TGF-β1, are fairly effective, and will increase the therapeutic options for patients with IBD (17)(18)(19)(20)(21). FMT has been proven to be highly successful in the treatment of recurrent and antibiotic refractory Clostridioides difficile infections, with a cure rate of up to 90% (22)(23)(24).…”

Anti-Inflammatory, Antioxidant, and Healing-Promoting Effects of Aloe vera Extract in the Experimental Colitis in Rats

“…Based on recent cohort studies, although with the variable in results, UC may exceed up to 83% in 10 years' follow-up confirming not only the importance of UC but also the need to find a new treatment for UC in the near future [51,52]. In this manner, more research in alternative medicines such as probiotics, dietary fibers, and herbal products has been suggested [53][54][55][56].…”

Novel cell-based therapies in inflammatory bowel diseases: the established concept, promising results

“…Studies showed that Treg cell therapy could be used as a potential treatment in inflammatory disorders such as IBDs [ 19 , 20 ]. Moreover, clinical trials which used autologous Treg cells, showed safety and efficacy of these cells for the treatment of CD [ 21 ]. A major issue in Treg-based therapy is safety since the systemic immunosuppression followed by Treg infusion is a crucial concern[ 22 ].…”