Update on pathogenesis and predictors of response of therapeutic strategies used in inflammatory bowel disease

Abstract

The search for biomarkers that characterize specific aspects of inflammatory bowel disease (IBD), has received substantial interest in the past years and is moving forward rapidly with the help of modern technologies. Nevertheless, there is a direct demand to identify adequate biomarkers for predicting and evaluating therapeutic response to different therapies. In this subset, pharmacogenetics deserves more attention as part of the endeavor to provide personalized medicine. The ultimate goal in this area is the adjustment of medication for a patient's specific genetic background and thereby to improve drug efficacy and safety rates. The aim of the following review is to utilize the latest knowledge on immunopathogenesis of IBD and update the findings on the field of Immunology and Genetics, to evaluate the response to the different therapies. In the present article, more than 400 publications were reviewed but finally 287 included based on design, reproducibility (or expectancy to be reproducible and translationable into humans) or already measured in humans. A few tests have shown clinical applicability. Other, i.e., genetic associations for the different therapies in IBD have not yet shown consistent or robust results. In the close future it is anticipated that this, cellular and genetic material, as well as the determination of biomarkers will be implemented in an integrated molecular diagnostic and prognostic approach to manage IBD patients.

Emerging Role and Therapeutic Implication of Wnt Signaling Pathways in Autoimmune Diseases

“…IBD primarily includes ulcerative colitis (UC), which causes long-lasting inflammation and ulcers in colon and rectum, and Crohn disease (CD), which can cause inflammation in any segment of the gastrointestinal tract. IBD has a genetic predisposition, and IBD patients are more prone to develop intestinal carcinomas [ 121 ].…”

Propionate Ameliorates Dextran Sodium Sulfate-Induced Colitis by Improving Intestinal Barrier Function and Reducing Inflammation and Oxidative Stress

“…Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a group of chronic inflammatory disorders of the gastrointestinal tract characterized by intestinal inflammation and mucosal damage ( Quetglas et al, 2015 ). It is commonly believed that intestinal barrier function destruction, intestinal flora disturbance, and immune dysfunction play important roles in the pathogenesis of IBD ( Quetglas et al, 2015 ; Loddo and Romano, 2015 ). Glucocorticoids, sulfasalazine, and immunosuppressive drugs have been traditionally used for the treatment and maintenance of ulcerative colitis.…”

Association between Genetic Polymorphisms and Response to Anti-TNFs in Patients with Inflammatory Bowel Disease

“…There are currently three TNFα antagonists available in the treatment of IBD: infliximab, adalimumab and golimumab, which are full-length antibodies and their Fc region is capable of complement fixation and Fc-receptor mediated biologic activities. These compounds exert a down-regulation of inflammatory cells in the inflamed bowel mucosa induced by apoptosis in TNF carrying cells [ 29 ].…”