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Lessons Learned From Trials Targeting Cytokine Pathways in Patients With Inflammatory Bowel Diseases

机译:从煽动性肠病患者靶向细胞因子途径的试验中学到的经验教训

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Insights into the pathogenesis of inflammatory bowel diseases (IBDs) have provided important information for the development of therapeutics. Levels of interleukin 23 (IL23) and T-helper (Th) 17 cell pathway molecules are increased in inflamed intestinal tissues of patients with IBD. Loss-of-function variants of the IL23-receptor gene (IL23R) protect against IBD, and, in animals, blocking IL23 reduces the severity of colitis. These findings indicated that the IL23 and Th17 cell pathways might be promising targets for the treatment of IBD. Clinical trials have investigated the effects of agents designed to target distinct levels of the IL23 and Th17 cell pathways, and the results are providing insights into IBD pathogenesis and additional strategies for modulating these pathways. Strategies to reduce levels of proinflammatory cytokines more broadly and increase anti-inflammatory mechanisms also are emerging for the treatment of IBD. The results from trials targeting these immune system pathways have provided important lessons for future trials. Findings indicate the importance of improving approaches to integrate patient features and biomarkers of response with selection of therapeutics.
机译:对炎症性肠病发病机制(IBD)的洞察力为治疗方法提供了重要信息。白细胞介素23(IL23)和T-辅助(TH)17细胞途径分子的水平在IBD患者发炎的肠组织中增加。 IL23受体基因(IL23R)的函数变体(IL23R)防止IBD,并且在动物中,阻断IL23降低了结肠炎的严重程度。这些发现表明IL23和TH17细胞途径可能是治疗IBD的有前途的靶标。临床试验研究了设计用于靶向IL23和TH17细胞途径的不同水平的药剂的影响,结果是对IBD发病机制的见解以及调制这些途径的额外策略。减少促炎细胞因子水平更广泛,增加抗炎机制的策略也正在促进IBD的治疗。针对这些免疫系统途径的试验结果为未来的试验提供了重要的课程。调查结果表明改善患者特征和患者响应的响应的方法的重要性的重要性。

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