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Abstract
Novel biologic agents that selectively target specific molecules and pathways have been developed recently for the management of inflammatory bowel disease (IBD). Anti-TNF-α, an antibody to TNF-α is one of the first newly developed drugs to dramatically improve the symptoms of patients with IBD. Therapy with anti-TNF-α demonstrates a new paradigm for management of IBD and early treatment with these drugs has demonstrated increased benefit. However, more than one-third of the patients have lost response to the drug. Also, there is the problem of antibody formation. Therefore, enormous efforts to develop novel drugs as an alternatives to anti-TNF-α are underway. Anti CD4+ T cell cytokine including IL-12/23 and IL-17 blockers, selective anti-adhesion molecules known as natalizumab, vedolizumab and alicaforsen, T-cell proliferation inhibitors, anti-inflammatory cytokines, immune stimulators, growth factors and mitogen activated protein kinase (MAPK) inhibitors are among the novel therapeutic agents that are currently being investigated for efficacy and safety in the management of IBD. The aim of this paper is to review current knowledge concerning the mechanism of action, the short and long term efficacy, and the safety of these novel biologic therapies, as well as that of anti-TNF-α, in IBD.
Figures and Tables
Table 1
Signal Molecules in Inflammatory Bowel Disease
TNF, Tumor necrosis factor; CD, cluster of differentiation; MAdCAM, mucosal addressin cell adhesion molecule; G-CSF, granulocyte colony stimulating factor; GM-CSF, granulocyte-monocyte stimulating factors; KGF, Keratinocyte growth factor; EGF, epidermal growth factor; MAPK, mitogen-activated protein kinase; JNK, Jun-N-terminal kinase
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