Pre- and Posttherapy Assessment of Intestinal Soluble Mediators in IBD: Where We Stand and Future Perspectives

F Scaldaferri,G Ianiro,G Bruno,V Petito,A Sgambato,L Lopetuso,V Gerardi,A Gasbarrini,G Cammarota

doi:10.1155/2013/391473

F Scaldaferri, G Ianiro + Show 7 more

Open Access

https://doi.org/10.1155/2013/391473

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Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory condition characterized by an abnormal immune response against food or bacterial antigens in genetically predisposed individuals. Several factors of innate and adaptive immune system take part in the inflammatory process, probably actively contributing in endoscopic and histological healing at molecular level. Although it is difficult to discriminate whether they are primary factors in determining these events or they are secondarily involved, it would be interesting to have a clear map of those factors in order to have a restricted number of potentially “good candidates” for mucosal healing. The present review will present a class of these factors and their modulation in course of therapy, starting from pathogenic studies involving several treatments associated with good clinical outcomes. This approach is meant to help in the difficult task of identifying “good candidates” for healing signatures, which could also be possible new therapeutic targets for clinical management of IBD patients.

Highlights

Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions characterized by chronic intestinal mucosa damage caused by an abnormal immune response against food or bacterial antigens [1,2,3]
Elevated levels of LTB4 have been reported in colonic tissue from patients with ulcerative colitis (UC): lipid extracted was analyzed by high-pressure liquid chromatography and biopsy specimens from patients affected by IBD and contained 254 ng of LTB4 per gram, in comparison with mucosa from normal subjects containing less than 5 ng of leukotriene B4 per gram of biopsy weight [34,35,36]. 5-ASA has shown ability to induce peroxisome proliferator-activated receptor γ (PPAR-γ) in vitro on HT29 colon epithelial cell line [37]. This result correlates with the finding that PPAR-γ, at mRNA and protein levels, is lower on specimens from patients affected by UC compared to Crohn’s disease (CD) or controls, and that use of and response to 5-ASA were associated with a reestablishment of its levels [38]
Several studies suggest that mucosal healing or amelioration of mucosal inflammation and clinical outcomes correlate with several changes in mucosal immunity

Summary

Introduction

Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions characterized by chronic intestinal mucosa damage caused by an abnormal immune response against food or bacterial antigens [1,2,3]. Probably “histological healing,” is becoming a reality close related to clinical practice, the “biological healing,” associated with an immunological restoration in gut mucosa, is until applied only in research field, usually in studies assessing the response to a certain therapy in course of IBD. Therapies will be divided into drugs acting systemically or locally with a broad spectrum of action and systemic drugs with a specific target

Systemic or Topical Drugs with Broad Spectrum of Action

Method

Systemic Drugs with Specific Targets

Methodology Used to Assess Immunological

Findings

Conclusions