Abstract
Healing of the inflamed mucosa (mucosal healing) is an emerging new goal for therapy and predicts clinical remission and resection-free survival in inflammatory bowel diseases (IBDs). The era of antitumor necrosis factor (TNF) antibody therapy was a remarkable progress in IBD therapy and anti-TNF agents led to mucosal healing in a subgroup of IBD patients; however, many patients do not respond to anti-TNF treatment highlighting the relevance of finding new targets for therapy of IBD. In particular, current studies are addressing the role of other anticytokine agents including antibodies against interleukin (IL)-6R, IL-13, and IL-12/IL-23 as well as new anti-inflammatory concepts (regulatory T cell therapy, Smad7 antisense, Jak inhibition, Toll-like receptor 9 stimulation, worm eggs). In addition, blockade of T-cell homing via the integrins α4β7 and the addressin mucosal vascular addressin cell adhesion molecule 1 (MAdCAM-1) emerges as a promising new approach for IBD therapy. Here, new approaches for achieving mucosal healing are discussed as well as their implications for future therapy of IBD.
Publication types
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Adaptive Immunity / drug effects
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Animals
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Antibodies, Monoclonal / therapeutic use
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Cell Adhesion / drug effects
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Cytokines / antagonists & inhibitors
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Cytokines / metabolism
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Humans
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Immunity, Innate
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Immunologic Factors / therapeutic use
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Immunosuppressive Agents / therapeutic use
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Inflammation Mediators / antagonists & inhibitors
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Inflammation Mediators / metabolism
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Inflammatory Bowel Diseases / immunology*
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Inflammatory Bowel Diseases / metabolism
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Inflammatory Bowel Diseases / microbiology
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Inflammatory Bowel Diseases / therapy*
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Intestinal Mucosa / immunology*
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Intestinal Mucosa / metabolism
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Intestinal Mucosa / microbiology
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Intestinal Mucosa / pathology
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Microbiota
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Signal Transduction / drug effects
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T-Lymphocyte Subsets / immunology
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T-Lymphocyte Subsets / metabolism
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T-Lymphocytes, Regulatory / immunology
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T-Lymphocytes, Regulatory / metabolism
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Tumor Necrosis Factor Inhibitors
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Tumor Necrosis Factors / metabolism
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Wound Healing / immunology*
Substances
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Antibodies, Monoclonal
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Cytokines
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Immunologic Factors
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Immunosuppressive Agents
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Inflammation Mediators
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Tumor Necrosis Factor Inhibitors
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Tumor Necrosis Factors