Classical and recent advances in the treatment of inflammatory bowel diseases

Braz J Med Biol Res. 2015 Feb;48(2):96-107. doi: 10.1590/1414-431X20143774. Epub 2014 Nov 28.

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use*
  • Cell- and Tissue-Based Therapy / methods
  • Colitis, Ulcerative / microbiology
  • Colitis, Ulcerative / therapy*
  • Crohn Disease / microbiology
  • Crohn Disease / therapy*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Inflammatory Bowel Diseases / therapy
  • Methotrexate / therapeutic use
  • Microbiota / drug effects
  • Probiotics / therapeutic use
  • Purines / therapeutic use
  • Quality of Life
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Immunosuppressive Agents
  • Purines
  • Tumor Necrosis Factor-alpha
  • Methotrexate