title: IL-23 Blockade for Crohn s disease: next generation of anti-cytokine therapy.
abstract: Adaptive immunity in intestinal inflammation may play a key role in the pathogenesis of Crohn's disease. In particular, interleukin (IL)-23 may be a key mediator in chronic intestinal inflammation by inducing the differentiation of naïve CD4 + T cells into Th17, with the production of several pro-inflammatory cytokines. Furthermore, IL-23 induces interferon-γ (IFN- γ) production from activated T cells, a critical cytokine in innate and adaptive immunity against infections. Areas covered: We aim to review the available data from literature regarding the role of IL-23, with a more specific focus on the recent progresses in the therapeutic modulation of this cytokine. Expert commentary: Increased knowledge regarding the role of IL-23 has allowed for the development of effective therapeutic progresses by blocking the IL-23 mediated pathways. Primary or secondary loss of response to anti-TNF therapies in Crohn's disease patients during the first year is widely described in literature: the development of new drugs, with alternative mechanisms of action, is thus a key point to consider for the optimal management of these subjects. Drugs blocking the IL-12/23 pathway showed a good efficacy and safety profile in immune-mediated diseases Further studies are necessary regarding the role of the single blockade of IL-23.
authors.affiliation: a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Furfaro
authors.affiliation: a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Gilardi
authors.affiliation: a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Allocca
authors.affiliation: a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy.|b Department of Internal Medicine and Medical Specialties , Sapienza University , Rome , Italy.
authors.forename: Clelia
authors.initials: C
authors.lastname: Cicerone
authors.affiliation: a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Correale
authors.affiliation: a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy.
authors.forename: Gionata
authors.initials: G
authors.lastname: Fiorino
authors.affiliation: a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy.|c Department of Biomedical Sciences , Humanitas University , Rozzano , Milan , Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
mesh_terms: D056704:Adaptive Immunity; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D019138:Antibodies, Blocking / Q000627:therapeutic use*; D003424:Crohn Disease / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007113:Immunity, Innate; D018836:Inflammation Mediators / Q000378:metabolism*; D007371:Interferon-gamma / Q000378:metabolism; D018664:Interleukin-12 / Q000378:metabolism; D053759:Interleukin-23 / Q000276:immunology / Q000378:metabolism*; D015398:Signal Transduction; D058504:Th17 Cells / Q000276:immunology*; D000069549:Ustekinumab / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D019138:Antibodies, Blocking; D018836:Inflammation Mediators; D053759:Interleukin-23; D018664:Interleukin-12; D007371:Interferon-gamma; D000069549:Ustekinumab
keywords: Crohn’s disease; anti-cytokine; biologics; interleukin-23; ustekinumab