Marco Bustamante-Bernal, Ihsan Al-Bayati, Marc J. Zuckerman
Department of Internal Medicine, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX, USA
Med Sci Rev 2016; 3:90-99
Crohn’s disease (CD) and ulcerative colitis (UC) are characterized by migration of inflammatory cells into the intestinal mucosa triggered by a dysregulated immune response involving T lymphocytes, macrophages, neutrophils, interleukins, and tumor necrosis factor-alpha (TNα). Medical treatment for CD and UC is focused on controlling the immune response with aminosalicylates, steroids, immunomodulators, and anti-TNF agents. However, some patients with moderate to severely active disease may become steroid-dependent or unresponsive to anti-TNF agents. This has led to the recognition of new targets to control the inflammatory process in CD and UC. Recently, the inhibition of leukocyte traffic to the intestinal mucosa has been recognized as a potential target for treatment. Integrins are transmembrane receptors involved in leukocyte adhesion to vascular endothelium, allowing migration across blood vessels to the inflammatory site. Specifically, the α4β7 integrin selectively inhibits leukocyte migration within the gastrointestinal tract. Vedolizumab, a humanized monoclonal antibody that binds to the α4β7 integrin, has emerged as new agent for the treatment of CD and UD, and has proven to be safe and effective in achieving clinical response and remission in patients with moderate to severely active disease.
Keywords: Colitis, Ulcerative, Crohn Disease, Inflammatory Bowel Diseases, Integrins