New Trends in Inflammatory Bowel Disease

Abstract

Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory disease of the gastrointestinal (GI) tract. In the past decade a shift in the treatment paradigm of IBD has ensued. The availability of drugs capable of inducing mucosal healing, combined with the recognition that IBD is not an intermittent disease, but rather a progressive one causing bowel damage and disability, led us to a more stringent strategy. Tailored therapy with more aggressive treatment in high-risk patients, treating beyond symptoms, intervening early before damage occurs, optimizing therapeutic regimens, and actively pursuing sustained remission and sustained control of inflammation are strategies that are slowly being incorporated in our clinical practice. Furthermore, new drugs targeting different immunological pathways, such as vedolizumab, have recently been approved and therefore more therapeutic resources for patients failing anti-tumour necrosis factor alpha (anti-TNFα) agents will be available.The future years look promising for IBD. Hopefully the new trends in IBD management, combined with new drugs, will make possible to change the course of disease and provide better therapy and quality of life for patients suffering from this disabling disease.

Effect of Loureirin B on Crohn’s disease rat model induced by TNBS via IL-6/STAT3/NF-κB signaling pathway

“…At present, it is believed that CD may be caused by mucosal damage caused by intestinal immune hyperactivity due to the infection, diet and other environmental factors. Immune abnormalities have been recognized to play a very important role in the pathogenesis of CD, including inflammatory transmitters, cytokines and immune regulation [39][40][41]. Nowadays, clinical treatment of CD is mainly based on drugs according to the severity of CD, and commonly used drugs are aminosalicylic acid, glucocorticoids, immunosuppressors and anti TNF-α biological agents [42].…”

Outcomes and Strategies to Support a Treat-to-target Approach in Inflammatory Bowel Disease: A Systematic Review

“…[1][2][3] The conventional approach to treatment of these conditions-collectively termed inflammatory bowel disease [IBD]-has focused on control of symptoms using a step-up pharmacological intervention strategy, with progressive intensification of therapy and/or surgical resection as the disease worsens or therapy fails to control symptoms. [4][5][6][7] Treatment options include non-specific therapies such as different formulations of the anti-inflammatory agent 5-aminosalicylic acid , glucocorticosteroids, immunomodulators, and more specific biologic therapy such as anti-tumour necrosis factor-alpha antibodies [anti-TNFα]. 5 More recent additions include anti-integrins, anti-interleukin 12/23 agents, and the JAK inhibitor tofacitinib.…”

“…[4][5][6][7] Treatment options include non-specific therapies such as different formulations of the anti-inflammatory agent 5-aminosalicylic acid , glucocorticosteroids, immunomodulators, and more specific biologic therapy such as anti-tumour necrosis factor-alpha antibodies [anti-TNFα]. 5 More recent additions include anti-integrins, anti-interleukin 12/23 agents, and the JAK inhibitor tofacitinib. 5,8 Surgical resection is usually reserved for patients with complications or those with intractable disease.…”

“…5 More recent additions include anti-integrins, anti-interleukin 12/23 agents, and the JAK inhibitor tofacitinib. 5,8 Surgical resection is usually reserved for patients with complications or those with intractable disease.…”

Biomarcadores Fecais Úteis Nas Doenças Inflamatórias Intestinais: Revisão Sistemática

“…Modelos experimentais e estudos clínicos propõem que esse surgimento é resultante da ação conjunta de fatores ambientais, imunológicos e genéticos que resultam em alterações na integridade da barreira mucosa intraluminal. O fluxo transepitelial de bactérias entéricas promove ativação da imunidade inata (7)(8)(9) . Os sintomas dos pacientes podem ser indicadores de inflamação e atividade da doença, mas são subjetivos e, muitas vezes, influenciados por outros fatores não inflamatórios da doença, como a fibrose.…”