IBD disease-modifying therapies: insights from emerging therapeutics. Issue 3 (March 2023)

• Record Type: Journal Article
• Authors: Kotla, Niranjan G.; Rochev, Yury
• Is Part Of: Trends in molecular medicine. Volume 29:Issue 3(2023)
• Page Start: 241
• Page End: 253
• Publication Date: 2023-03
• Subjects: inflammatory bowel disease -- intestinal inflammation -- mucosal epithelium -- dysregulated gut barrier -- biomaterials -- gut microbiota; Molecular biology -- Periodicals; Pathology, Molecular -- Periodicals; Physiology, Pathological -- Periodicals; 572.8
• DOI: 10.1016/j.molmed.2023.01.001
• Languages: English
• ISSNs: 1471-4914

Abstract

Highlights: Despite advances in new drug approvals for the treatment of inflammatory bowel disease (IBD), challenges remain to achieve complete mucosal epithelial repair, regeneration, and restitution. Restoration of the dysregulated intestinal epithelium with novel therapeutic modalities could be a future target, and there is a pressing need to understand the mechanistic aspects of disease-modifying biotherapeutics. Biomaterial-based bioengineering strategies and gut microbiota-derived metabolites have demonstrated potential therapeutic advantages in IBD by modulating inflammation, permeability, and mucosal epithelium repair, improving tissue homeostasis, and enriching commensal gut microbiota. Investigations of alternative therapies are essential, particularly those that restore the dysregulated barrier and represent an area of unmet need that could be addressed by novel combinatorial therapeutics or emerging barrier-repairing strategies. Abstract: Inflammatory bowel disease (IBD) pathogenesis is associated with gut mucosal inflammation, epithelial damage, and dysbiosis leading to a dysregulated gut mucosal barrier. However, the extent and underlying mechanisms remain largely unknown. Current treatment regimens have focused mainly on treating IBD symptoms; however, such treatment strategies do not address mucosal epithelial repair, barrier homeostasis, or intestinal dysbiosis. Although attempts have been made to identify new therapeutic modalities to enhance gut barrier functions, these are at an early developmental stage and have not been wholly successful. We review conventional therapies, the possible relevant role of gut barrier-protecting agents, and biomaterial strategies relating to combination therapies that may pave the way towards developing new therapeutic approaches for IBD.