title: What's the next best cytokine target in IBD?
abstract: In the gut of patients with inflammatory bowel disease (IBD), immune and nonimmune cells produce large amounts of cytokines that drive the inflammatory process leading to the tissue damage. Cytokine blockers, such as anti-tumor necrosis factor alpha (TNF-α), have been used with some success in IBD. However, not all patients respond, and the therapeutic effects wane with time, demonstrating the need for more effective and long-lasting antiinflammatory strategies. A key question is whether neutralizing other proinflammatory cytokines such as interleukin (IL)-12, IL-21, IL-27, or IL-33 will lead to a better clinical response than with anti-TNF-α antibodies. Equally, we now know that IBD-related inflammation is marked by defective production/activity of antiinflammatory cytokines, and there are strategies to correct these defects. An alternative approach is to try to target individual therapies to individual patients, to improve clinical efficacy in subsets of patients, but this has proven difficult. Here we try to evaluate the potential of each of these choices.
authors.affiliation: Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK. t.t.macdonald@qmul.ac.uk
authors.forename: Thomas T
authors.initials: TT
authors.lastname: MacDonald
authors.forename: Paolo
authors.initials: P
authors.lastname: Biancheri
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Sarra
authors.forename: Giovanni
authors.initials: G
authors.lastname: Monteleone
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D016207:Cytokines / Q000037:antagonists & inhibitors*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents; D016207:Cytokines