Pharmacological Therapy in Inflammatory Bowel Diseases: A Narrative Review of the Past 90 Years

Abstract

Inflammatory Bowel Diseases had their first peak in incidence in countries in North America, Europe, and Oceania and are currently experiencing a new acceleration in incidence, especially in Latin America and Asia. Despite technological advances, 90 years after the development of the first molecule for the treatment of IBD, we still do not have drugs that promote disease remission in a generalized way. We carried out a narrative review on therapeutic advances in the treatment of IBD, the mechanisms of action, and the challenges facing the therapeutic goals in the treatment of IBD. Salicylates are still used in the treatment of Ulcerative Colitis. Corticosteroids have an indication restricted to the period of therapeutic induction due to frequent adverse events, while technologies with less systemic action have been developed. Most immunomodulators showed a late onset of action, requiring a differentiated initial strategy to control the disease. New therapeutic perspectives emerged with biological therapy, initially with anti-TNF, followed by anti-integrins and anti-interleukins. Despite the different mechanisms of action, there are similarities between the general rates of effectiveness. These similar results were also evidenced in JAK inhibitors and S1p modulators, the last therapeutic classes approved for the treatment of IBD.

Therapeutic Applications of Aggregatibacter actinomycetemcomitans Leukotoxin

“…Inflammatory bowel diseases (IBDs) such as Crohn's disease (CD) and ulcerative colitis are the result of an over-reactive immune system that targets the gastrointestinal tissue, resulting in inflammation and subsequent abdominal pain, bleeding, weight loss, and malnutrition [53][54][55][56][57]. Several studies have shown that LFA-1 plays a crucial role in the development of the disease.…”

Antioxidant and Anti-Inflammatory Phytochemicals for the Treatment of Inflammatory Bowel Disease: A Systematic Review

“…Gut microbiota and its dysregulation are one of the environmental factors that also play a key role in the immune-mediated disease process of IBD. Thus, various medical therapies target these pathophysiologic pathways [3,4].…”

Intestinal Membrane Function in Inflammatory Bowel Disease

“…Among the diseases mentioned above, IBD is one of the contexts in which barrier function has been most intensively researched. IBD is a collective term for a group of inflammatory diseases of the gut, including ulcerative colitis (UC) and Crohn’s disease (CD), and it is a chronic inflammatory disease of unknown cause [ 9 , 10 ]. It was originally described as a disease that more commonly affects Caucasians, but now, patients are rapidly increasing in Asia, including Japan, although there are limited epidemiological data from developing countries [ 11 , 12 , 13 , 14 ].…”

“…This review summarizes intestinal barrier function, including the microbiome involvement (Figure 1), and further focuses on a comparison of the barrier functions of tight junction proteins and the membrane permeability between patients with UC or CD and healthy subjects. (CD), and it is a chronic inflammatory disease of unknown cause [9,10]. It was originally described as a disease that more commonly affects Caucasians, but now, patients are rapidly increasing in Asia, including Japan, although there are limited epidemiological data from developing countries [11][12][13][14].…”