Evaluation of new therapies for inflammatory bowel disease

Abstract

The pathophysiology of inflammatory bowel disease (IBD) is gradually being unravelled and new therapies are being developed to target the disturbed biological processes. This article outlines the clinical features of IBD, its current therapy and pathogenesis. The difficulties for clinical pharmacologists and gastroenterologists associated with designing, executing and interpreting clinical trials in IBD are then discussed. The final section reviews methods that can used to demonstrate the pharmacological actions of new treatments in patients with IBD. It is emphasized that proof of the therapeutic efficacy of a novel agent with a specific mechanism of action yields not only clinical benefit to patients with IBD, but also indicates the importance of the targeted biochemical pathway in the pathogenesis of the disease.

Mentha longifolia protects against acetic-acid induced colitis in rats

“…Being a worldwide disease, IBD is a main cause of economic burden and duty nonappearance. In CD, the inflammation is transmural and affects the whole length of the GI tract while in UC the inflammation is superficial and affects only the colon and rectum (Carty et al, 2003). Multiple antiinflammatory and/or immunomodulatory drugs are used for treatment of IBD, including 5-aminosalicylic acid compounds (e.g., sulfasalazine), corticosteroids, methotrexate, and anti-tumor necrosis factor-α agents (e.g., infliximab).…”

A Strategy to Identify Stable Membrane-Permeant Peptide Inhibitors of Myosin Light Chain Kinase

“…For example, infliximab, which has revolutionized CD therapy, is associated with reactivation of mycobacterial infections. Thus, non-immunosuppressive therapeutic options for the treatment of IBD and other diseases of the GI tract are needed (3).…”

The role of microbial agents in the pathogenesis of inflammatory bowel disease

“…Ulcerative colitis, in contrast to Crohn's disease, is limited to the rectum and colon area [4]. The inflammation usually occurs in the rectum and lower part of the colon, but it may affect the entire colon.…”

“…It is characterised by transmural, patchy, granulomatous inflammation of any part of the gastrointestinal tract, from the oropharyx to the perianal area [4], although it is common in the ileocaecal area. The inflammatory infiltrate consists of T and B lymphocytes, macrophages and plasma cells [2].…”

“…The symptoms of IBD mostly comprise signs of a chronic relapsing and remitting course [2], and are characterised by exacerbations and remissions of mucosal inflammation and ulceration [3]. In some patients, IBD is associated with extra-intestinal manifestations involving the liver, skin, eyes and/or joints [4]. Although both Crohn's disease and ulcerative colitis have a number of similarities in their clinical presentations, the characteristic features are different and characterised by specific complications.…”