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Immunomodulators in Inflammatory Bowel Disease: An Emerging Role for Biologic Agents

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Abstract

Crohn’s disease and ulcerative colitis, collectively referred to as inflammatory bowel diseases (IBD), are the result of an aberrant immune response to ubiquitous antigens in a genetically susceptible host. In the past, treatment has focused on immunosuppression with the aim of achieving symptom-free remission. Over the last two decades, with a better understanding of the underlying pathomechanisms and an increased knowledge of the natural disease course, mucosal healing (the endoscopic absence of visible inflammation) has become the target of therapy. Anti-tumor necrosis factor (TNF)-α therapy was introduced in the late 1990s and, for the first time, targeted and effective medication became available. However, these medications are not without significant side effects, and long-term efficacy is only achieved in about one third of patients. Alongside anti-TNF-α agents, a variety of other drugs targeting different aspects of the immune system will become available over the next few years. This review aims to provide a brief summary of immunologic pathways involved in IBD and shows where current and new drugs fit into these pathways.

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Acknowledgements and Disclosures

Research by Roslyn Kemp and Elliott Dunn is supported by the Jack Thomson Arthritis Fund and the H.S. and J.C. Anderson Trust. Michael Schultz has received speaker fees and is a member of the AbbVie Ltd. and Janssen-Cilag Pty Ltd. New Zealand Inflammatory Bowel Disease Advisory Boards.

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Authors and Affiliations

  1. Department of Microbiology and Immunology, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand

    Roslyn Kemp & Elliott Dunn

  2. Department of Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand

    Michael Schultz

  3. Gastroenterology Unit, Southern District Health Board, Dunedin, New Zealand

    Michael Schultz

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  1. Roslyn Kemp
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  2. Elliott Dunn
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Correspondence to Michael Schultz.

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Kemp, R., Dunn, E. & Schultz, M. Immunomodulators in Inflammatory Bowel Disease: An Emerging Role for Biologic Agents. BioDrugs 27, 585–590 (2013). https://doi.org/10.1007/s40259-013-0045-2

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