Targeting Specific Immunologic Pathways in Crohn's Disease

Gastroenterol Clin North Am. 2017 Sep;46(3):577-588. doi: 10.1016/j.gtc.2017.05.009. Epub 2017 Jul 19.

Abstract

Understanding the immunologic pathways in intestinal inflammation is crucial for the development of new therapies that can maximize patient response and minimize toxicity. Targeting integrins and cytokines is intended to control leukocyte migration to effector sites or inhibit the action of proinflammatory cytokines. New approaches to preventing leukocyte migration may target integrin receptors expressed on the intestinal vascular endothelium. The interleukin (IL)-12/IL-23 pathway has been a therapeutic target of interest in controlling active Crohn's disease (CD). New therapeutic approaches in CD may involve the enhancement of anti-inflammatory cytokine pathways and modulation of cellular responses and intranuclear signals associated with intestinal inflammation.

Keywords: Crohn's disease; Immunology; Inflammatory bowel diseases; Target therapy.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Cell Adhesion Molecules / metabolism
  • Cell Movement / immunology
  • Crohn Disease / drug therapy*
  • Crohn Disease / immunology
  • Endothelium, Vascular / metabolism
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Immunologic Factors / therapeutic use*
  • Integrins / metabolism
  • Interleukin-12 / immunology
  • Interleukin-12 Subunit p40 / immunology
  • Interleukin-23 / immunology
  • Janus Kinase Inhibitors / therapeutic use*
  • Janus Kinases / immunology
  • Leukocytes / immunology
  • Natalizumab / therapeutic use
  • Piperidines / therapeutic use
  • Pyrimidines / therapeutic use
  • Pyrroles / therapeutic use
  • Signal Transduction / immunology
  • Th1 Cells / immunology
  • Th17 Cells / immunology
  • Ustekinumab / therapeutic use

Substances

  • Antibodies, Monoclonal, Humanized
  • Cell Adhesion Molecules
  • Gastrointestinal Agents
  • Immunologic Factors
  • Integrins
  • Interleukin-12 Subunit p40
  • Interleukin-23
  • Janus Kinase Inhibitors
  • Natalizumab
  • Piperidines
  • Pyrimidines
  • Pyrroles
  • Interleukin-12
  • tofacitinib
  • vedolizumab
  • Janus Kinases
  • Ustekinumab