Targeting therapy in pediatric inflammatory bowel disease

Abstract

Progress in our understanding of the interaction between the environment and the immune system in disease pathogenesis has led to major advancements in the area of inflammatory bowel disease (IBD) therapeutics. Biotechnology is keeping pace with these scientific advances. Current therapies target the various elements of the inflammatory cascade implicated in the pathogenesis of IBD. The anti-inflammatory and immunomodulatory properties of the pharmacologic therapies used in IBD vary from actions that are extremely broad to those that are cellular or cytokine specific. Despite the various therapeutic options available for IBD patients, chosen therapies should be based on the overall treatment goal for individual patients. Therapeutics can be broadly categorized as induction therapies (goal to treat active disease) and maintenance therapies (goal to prevent relapse of disease). The modern thinking behind drug development is that IBD therapy should be disease modifying so to avoid complications and alter the long term natural history of disease. This review will cover both current and emerging agents and highlight the pathogenesis of IBD and how it relates to therapeutic targets.

Analysis of current treatments used in clinical practice in a pediatric summer camp population for children with inflammatory bowel disease

“…IBD medications are shown in Figure 1 and comparison between the groups with respect to medication use and dose is shown in Table 2. The medication dosages were consistent with published pediatric guidelines 15. Of the 121 applicants with CD, 13 (10.7%) were on an antibiotic, 10 (8.3%) were on corticosteroids, and 56 (46.3%) were on a 5‐ASA, 15 of whom were on a 5‐ASA as monotherapy.…”

Benefit of nicorandil using an immunologic murine model of experimental colitis

“…Moreover, various herbal extracts [7][8][9][10], N-acetylcysteine (NAC) [11] and probiotics [12][13][14][15] have been suggested for the treatment of IBD, and the effectiveness of antibiotic therapy in IBD has been investigated [16,17]. Unfortunately, it is very difficult to reach maximum efficacy and quality of life because of the side effects [18] associated with the treatments described above. Therefore it is essential to develop other medicines with novel mechanisms, high efficacy, and fewer side effects.…”

On the benefits of silymarin in murine colitis by improving balance of destructive cytokines and reduction of toxic stress in the bowel cells

“…The main challenge is overcoming the limitations in using these medical agents. In fact, low efficacy and high incidence of side effects, alongside unreachable remission, are the major difficulties in management of IBD [9]. Recent investigations have suggested novel strategies.…”