Apprehending Ulcerative Colitis Management With Springing Up Therapeutic Approaches: Can Nanotechnology Play a Nascent Role?

Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disorder that causes inflammation in the colon and rectum and can be lethal to the patients. The dysbiotic intestinal microbiome is considered a major factor of UC, yet it needs more evidences. As there is no cure for UC, anti-inflammatory drugs, potent steroids, immunomodulatory drugs, or even surgery is used to manage the disease. The purpose of this review is to focus on the underlying factors involved in the disease pathogenicity, including host gut microbiome and novel therapies for treatment of UC. Due to disruption of intestinal epithelial layers, the intestinal microflora interacts with immune cells in the lamina propria, which in turn provokes an inflammatory response, which is subsequently exacerbated in the colon. Anti–tumor necrosis factor (anti-TNF), anti-integrin, Janus kinase inhibitors, siRNA, fecal microbiome transfer, synbiotics, and many other small molecules such as ozanimod are emerging as potential therapy for UC. Moreover, a nanoparticle-based drug delivery system enhances localized delivery of the drug to the inflammatory sites. Additionally, herbal-derived nanoparticles are also emerging as a novel drug delivery system in disease management. The homeostasis of gut microbiota is crucial for both prevention and remission of UC. Synbiotics and fecal microbiome transfer is emerging as potential treatment strategies for management of UC. The combination of multiple therapies may have durable therapeutic outcomes against the debilitating condition of UC. The outcome of the ongoing clinical trials of novel drugs will define the new therapeutic approaches in the treatment of UC for long-term remission.