Inflammatory Bowel Disease Treatments and Predictive Biomarkers of Therapeutic Response

Abstract

Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammation of the gastrointestinal tract with a highly heterogeneous presentation. It has a relapsing and remitting clinical course that necessitates lifelong monitoring and treatment. Although the availability of a variety of effective therapeutic options including immunomodulators and biologics (such as TNF, CAM inhibitors) has led to a paradigm shift in the treatment outcomes and clinical management of IBD patients, some patients still either fail to respond or lose their responsiveness to therapy over time. Therefore, according to the recent Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) recommendations, continuous disease monitoring from symptomatic relief to endoscopic healing along with short- and long-term therapeutic responses are critical for providing IBD patients with a tailored therapy algorithm. Moreover, considering the high unmet need for novel therapeutic approaches for IBD patients, various new modulators of cytokine signaling events (for example, JAK/TYK inhibitors), inhibitors of cytokines (for example IL-12/IL-23, IL-22, IL-36, and IL-6 inhibitors), anti-adhesion and migration strategies (for example, β7 integrin, sphingosine 1-phosphate receptors, and stem cells), as well as microbial-based therapeutics to decolonize the bed buds (for example, fecal microbiota transplantation and bacterial inhibitors) are currently being evaluated in different phases of controlled clinical trials. This review aims to offer a comprehensive overview of available treatment options and emerging therapeutic approaches for IBD patients. Furthermore, predictive biomarkers for monitoring the therapeutic response to different IBD therapies are also discussed.

Advancing the precision management of inflammatory bowel disease in the era of omics approaches and new technology

“…In addition, low triggering receptor expressed on myeloid cells 1 (TREM1) expression in both whole peripheral blood samples and intestinal biopsy samples, which indicated a complete macrophage autophagy pathway, could be used to predict a good anti-TNF response in IBD patients[ 55 ]. Antibodies including anti-drug antibodies (ADA), pANCA and anti-OmpC ( Escherichia coli outer membrane porin) were also found to be associated with the response to infliximab[ 56 ]. In the aspect of relapse after discontinuation of anti-TNF therapy, mucosal TNF gene expression and IL1RL1-transcripts might play a role[ 57 ].…”

Impact of Obesity on the Course of Management of Inflammatory Bowel Disease—A Review

“…Meanwhile, inflammatory markers produced by adipose tissue constitute a parallel pathology triggering morphological dysfunction of the gastrointestinal tract. This kind of self-perpetuating loop with its consequences can be observed in the natural history of IBD [ 175 ]. Considering IBD, a significant role of malnutrition in its course must be emphasized, together with possible sarcopenia in the consequence.…”

Saccharomyces cerevisiae prevents postoperative recurrence of Crohn's disease modeled by ileocecal resection in HLA-B27 transgenic rats

“…Several therapeutic strategies, including the use of antibiotics[ 13 ], pre/probiotics[ 14 ] and fecal microbiota transplantation[ 15 ], have been proposed to target the intestinal flora in CD. Due to side effects or limited efficacy, their routine utilization cannot be recommended[ 16 , 17 ].…”