[Therapeutic regimens using monoclonal antibodies in gastroenterology]

Internist (Berl). 2019 Oct;60(10):1043-1058. doi: 10.1007/s00108-019-00682-2.
[Article in German]

Abstract

Therapeutic regimens using monoclonal antibodies have been implemented in clinical daily practice for various gastroenterological diseases, for therapeutic strategies in gastrointestinal (GI) oncology, and infectious diseases of the gastrointestinal tract. The main indications remain the therapy of chronic inflammatory bowel disease and in GI oncology. A new field has opened for targeted therapy with monoclonal antibodies of recurrent Clostridium difficile infection. In the nomenclature of monoclonal antibodies, the endings of the substances indicate the production or degree of "humanization" of the respective antibodies ("umab": fully human, recombinant antibody; "ximab": chimeric antibody with variable murine domain). For chronic inflammatory bowel disease, monoclonal antibodies has been developed to interfere with molecular targets of the inflammatory cascade in the underlying pathogenesis (tumor necrosis factor‑α, interleukin-12 and -23; α4β7-integrins). The development of targeted therapies in the treatment of GI malignancies, monoclonal antibodies has been developed to interfere with substantial pathways of proliferation and apoptosis as well as neoplastic vascularization and neovascularization (e.g., vascular endothelial growth factor [VEGF] and VEGF receptor antibodies, epidermal growth factor receptor antibodies, HER2/neu antibodies). In the current review, we provide a summary of the current applications of monoclonal antibodies in the therapeutic treatment of gastroenterological diseases.

Keywords: Colitis, ulcerative; Colorectal neoplasms; Crohn disease; Molecular targeted therapy; Stomach neoplasms.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use*
  • Antineoplastic Agents, Immunological
  • Colitis, Ulcerative / drug therapy
  • Colorectal Neoplasms / drug therapy
  • Crohn Disease / drug therapy
  • ErbB Receptors / drug effects
  • Gastroenterology
  • Gastrointestinal Diseases / drug therapy*
  • Humans
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use*
  • Inflammatory Bowel Diseases / drug therapy*
  • Mice
  • Molecular Targeted Therapy / methods*
  • Receptors, Vascular Endothelial Growth Factor / drug effects
  • Stomach Neoplasms / drug therapy
  • Vascular Endothelial Growth Factor A

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • Immunologic Factors
  • Vascular Endothelial Growth Factor A
  • ErbB Receptors
  • Receptors, Vascular Endothelial Growth Factor