Gut-Selective Integrin-Targeted Therapies for Inflammatory Bowel Disease

J Crohns Colitis. 2018 Aug 22;12(suppl_2):S653-S668. doi: 10.1093/ecco-jcc/jjy060.

Abstract

Integrins are cell surface receptors with bidirectional signalling capabilities that can bind to adhesion molecules in order to mediate homing of leukocytes to peripheral tissues. Gut-selective leukocyte homing is facilitated by interactions between α4β7 and its ligand, mucosal addressin cellular adhesion molecule-1 [MAdCAM-1], while retention of lymphocytes in mucosal tissues is mediated by αEβ7 binding to its ligand E-cadherin. Therapies targeting gut-selective trafficking have shown efficacy in inflammatory bowel disease [IBD], confirming the importance of leukocyte trafficking in disease pathobiology. This review will provide an overview of integrin structure, function and signalling, and highlight the role that these molecules play in leukocyte homing and retention. Anti-integrin therapeutics, including gut-selective antibodies against the β7 integrin subunit [etrolizumab] and the α4β7 integrin heterodimer [vedolizumab and abrilumab], and the non-gut selective anti-α4 integrin [natalizumab], will be discussed, as well as novel targeting approaches using small molecules.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Cell Adhesion Molecules
  • Cell Movement / drug effects
  • Gastrointestinal Agents / therapeutic use*
  • Gastrointestinal Tract / metabolism
  • Humans
  • Immunoglobulins / metabolism
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / immunology
  • Inflammatory Bowel Diseases / metabolism
  • Integrins / antagonists & inhibitors
  • Integrins / metabolism*
  • Lymphocytes / immunology
  • Lymphocytes / metabolism*
  • Molecular Targeted Therapy
  • Mucoproteins / antagonists & inhibitors
  • Mucoproteins / metabolism
  • Natalizumab / therapeutic use*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Cell Adhesion Molecules
  • Gastrointestinal Agents
  • Immunoglobulins
  • Integrins
  • MADCAM1 protein, human
  • Mucoproteins
  • Natalizumab
  • integrin alpha4beta7
  • integrin alphaEbeta7
  • ontamalimab
  • vedolizumab
  • etrolizumab
  • abrilumab