Title:Inflammatory Bowel Disease: Etiology, Pathogenesis and Current Therapy
Volume: 20
Issue: 7
Author(s): Joshua K. Ko and Kathy K. Auyeung
Affiliation:
Keywords:
Inflammatory bowel disease, neutrophils, cytokines, adhesion molecules, immunomodulation, reactive oxygen/nitrogen metabolites,
pharmacotherapy.
Abstract: Ulcerative colitis (UC) and Crohn’s disease (CD) constitute the two major groups of idiopathic disorders in inflammatory
bowel disease (IBD). Environmental factors, genetic factors and immune responses have been considered as the major etiology of IBD.
Despite the diversified pathogenesis of the disease, no guaranteed curative therapeutic regimen has been developed so far. This review
summarizes the knowledge on the pathophysiology and current treatment approaches of IBD. Since IBD is caused by excessive and tissue-
disruptive inflammatory reactions of the gut wall, down-regulation of the immune responses may allow the damaged mucosa to heal
and reset the physiological functions of the gut back to normal. Current pharmacotherapy through modulation of neutrophil-derived factors,
cytokines, adhesion molecules and reactive oxygen/nitrogen metabolites has been utterly described. Categories of treatment modalities
include corticosteroids, aminosalicylates, immunomodulators, antibiotics, probiotics, and a series of unique novel agents. The use of
anti-tumor necrosis factor monoclonal antibody (Infliximab), recombinant anti-inflammatory cytokines and related gene therapy has been
covered. In addition, discussions on dietary supplementation and heparin treatment are also included. The anti-inflammatory and immunoregulatory
potential of investigational agents such as nicotine and the filtered protective compounds from tobacco smoke, as well as
active herbal medicinal compounds were tested in our previous experimental works, whereas promising findings have been presented
here. With the discovery of novel target-oriented agents, more effective and relatively harmless approaches of IBD therapy could be established
to achieve a curative outcome. Indeed, more experimental and clinical studies are needed to confirm the relevance of these
therapies.
