Antisense inhibition of ICAM-1 expression as therapy provides insight into basic inflammatory pathways through early experiences in IBD.
BACKGROUND
Alicaforsen (ISIS 2302), an antisense to intercellular adhesion molecule-1 (ICAM-1) (CD54), was designed to inhibit ICAM-1 expression. ICAM-1 seems to play a role in cell-mediated inflammation, specifically cell trafficking. For this reason, it may be useful in a variety of immune-mediated diseases, including inflammatory bowel disease.


OBJECTIVE
To evaluate the use of alicaforsen in clinical trials to understand its efficacy and side effects, as well as assess for evidence that may offer insight into disease pathways.


METHODS
We evaluate all of the available, published trials, with a focus on the prospective, randomized trials.


CONCLUSIONS
Systemic treatment for Crohn's disease has not revealed significant effect. Topical enemas for ulcerative colitis have demonstrated some effect in secondary outcomes, and initial studies in pouchitis are promising. In general, the compound has been well tolerated and safe.
Philpott
Jessica R
JR
University of Oklahoma Department of Digestive Diseases, Oklahoma City, OK, USA.
Miner
Philip B
PB
D002986:Clinical Trials as Topic; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D016376:Oligonucleotides, Antisense / Q000627:therapeutic use*; D054735:Phosphorothioate Oligonucleotides / Q000627:therapeutic use*
D016376:Oligonucleotides, Antisense; D054735:Phosphorothioate Oligonucleotides; D018799:Intercellular Adhesion Molecule-1; C089753:alicaforsen