Interrogating host immunity to predict treatment response in inflammatory bowel disease
File(s)
Accepted version
OA Location
Author(s)
Digby-Bell, Jonathan L
Atreya, Raja
Monteleone, Giovanni
Powell, Nick
Type
Journal Article
Abstract
IBD treatment is undergoing a transformation with an expanding repertoire of drugs targeting different aspects of the immune response. Three novel classes of drugs have emerged in the past decade that target leukocyte trafficking to the gut (vedolizumab), neutralize key cytokines with antibodies (ustekinumab) and inhibit cytokine signalling pathways (tofacitinib). In advanced development are other drugs for IBD, including therapies targeting other cytokines such as IL-23 and IL-6. However, all agents tested so far are hampered by primary and secondary loss of response, so it is desirable to develop personalized strategies to identify which patients should be treated with which drugs. Stratification of patients with IBD by clinical parameters alone lacks sensitivity, and alternative modalities are now needed to deliver precision medicine in IBD. High-resolution profiling of immune response networks in individual patients is a promising approach and different technical platforms, including in vivo real-time molecular endoscopy, tissue transcriptomics and germline genetics, are promising tools to help predict responses to specific therapies. However, important challenges remain regarding the clinical utility of these technologies, including their scalability and accessibility. This Review focuses on unravelling some of the complexity of mucosal immune responses in IBD pathogenesis and how current and emerging analytical platforms might be harnessed to effectively stratify and individualise IBD therapy.
Date Issued
2020-01-01
Date Acceptance
2019-10-14
Citation
Nature Reviews Gastroenterology and Hepatology, 2020, 17 (1), pp.9-20
ISSN
1759-5045
Publisher
Nature Research (part of Springer Nature)
Start Page
9
End Page
20
Journal / Book Title
Nature Reviews Gastroenterology and Hepatology
Volume
17
Issue
1
Copyright Statement
© 2019 Springer Nature Limited.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000504707500007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
TUMOR-NECROSIS-FACTOR
INNATE LYMPHOID-CELLS
FECAL MICROBIOTA TRANSPLANTATION
ACTIVE ULCERATIVE-COLITIS
SEVERE CROHNS-DISEASE
GENOME-WIDE ASSOCIATION
FACTOR-ALPHA
MAINTENANCE THERAPY
DOUBLE-BLIND
INDUCTION THERAPY
Publication Status
Published
Date Publish Online
2019-11-25