Inflammatory Bowel Disease Drugs: A Focus on Autophagy

J Crohns Colitis. 2017 Jan;11(1):118-127. doi: 10.1093/ecco-jcc/jjw127. Epub 2016 Jul 5.

Abstract

Inflammatory bowel disease [IBD] is characterized by chronic inflammation of the gastrointestinal tract. Medications such as corticosteroids, thiopurines, immunomodulators and biologic agents are used to induce and maintain remission; however, response to these drugs is variable and can diminish over time. Defective autophagy has been strongly linked to IBD pathogenesis, with evidence showing that enhancing autophagy may be therapeutically beneficial by regulating inflammation and clearing intestinal pathogens. It is plausible that the therapeutic effects of some IBD drugs are mediated in part through modulation of the autophagy pathway, with studies investigating a wide range of diseases and cell types demonstrating autophagy pathway regulation by these agents. This review will highlight the current evidence, both in vitro and in vivo, for the modulation of autophagy by drugs routinely used in IBD. A clearer understanding of their mechanisms of action will be invaluable to utilize these drugs in a more targeted and personalized manner in this diverse and often complex group of patients.

Keywords: Autophagy; Crohn’s disease; IBD; drugs.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Autophagy / drug effects*
  • Autophagy / physiology
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / physiopathology
  • Crohn Disease / drug therapy
  • Crohn Disease / physiopathology
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / physiopathology
  • Signal Transduction / drug effects
  • Signal Transduction / physiology

Substances

  • Anti-Inflammatory Agents
  • Gastrointestinal Agents