Advances in understanding the role of cytokines in inflammatory bowel disease

Expert Rev Gastroenterol Hepatol. 2018 Sep;12(9):907-915. doi: 10.1080/17474124.2018.1503053. Epub 2018 Jul 30.

Abstract

Cytokines represent the key pathophysiologic elements that govern the initiation, progression, and, in some circumstances, the resolution of the inflammation occurring in inflammatory bowel disease (IBD). Areas covered: In this review, we will focus on the main effector and anti-inflammatory cytokines produced in IBD and discuss the results of recent trials in which cytokine-based therapy has been used for treating IBD patients. Expert commentary: The possibility to sample mucosal biopsies from IBD patients and analyze which molecular pathways are prominent during the active phases of the disease and the easy access to various models of experimental colitis has largely advanced our understanding about the role of cytokines in IBD. These progresses have facilitated the development of several therapeutic compounds, which either target inflammatory cytokines or enhance the regulatory function of immunosuppressive cytokines. While some of such drugs are effective in the induction and maintenance of remission of the disease, other compounds are not useful for attenuating the ongoing mucosal inflammation, thus establishing a hierarchical scale of the relevance of cytokines in IBD. Further work is needed to identify biomarkers, which could help personalize cytokine-targeted therapy and minimize potential side effects.

Keywords: Crohn’s disease; JAK; Smad7; mucosal immunity; ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / immunology
  • Colitis, Ulcerative / metabolism*
  • Colon / drug effects
  • Colon / immunology
  • Colon / metabolism*
  • Crohn Disease / diagnosis
  • Crohn Disease / drug therapy
  • Crohn Disease / immunology
  • Crohn Disease / metabolism*
  • Cytokines / antagonists & inhibitors
  • Cytokines / immunology
  • Cytokines / metabolism*
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Immunity, Mucosal
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / immunology
  • Inflammation Mediators / metabolism*
  • Intestine, Small / drug effects
  • Intestine, Small / immunology
  • Intestine, Small / metabolism*
  • Signal Transduction

Substances

  • Anti-Inflammatory Agents
  • Cytokines
  • Gastrointestinal Agents
  • Inflammation Mediators