Biologische Therapie chronisch-entzündlicher Darmerkrankungen

Zusammenfassung

Biologische Therapien bei der Behandlung der chronisch-entzündlichen Darmerkrankungen spiegeln den exponenziellen Wissenszuwachs über das menschliche Immunsystem und insbesondere über die Mechanismen von intestinalen Entzündungen in der letzten Dekade wider. Das bessere Verständnis der (Entzündungs-)Mechanismen chronisch-entzündlicher Darmerkrankungen ist das Ergebnis klinischer Forschung und der Untersuchungen an genetisch manipulierten Tiermodellen. Es hat großes Interesse an der Entwicklung und Erprobung neuer Medikamente mit neuartigen Wirkmechanismen hervorgerufen. Diese Übersicht gibt einen Überblick über die Wirkmechanismen von Biologika (Antikörper gegen proinflammatorische Zytokine, Antikörper gegen T-Zellen, antiinflammatorische Zytokine, Adhäsionsmolkülblocker, Wachstumsfaktoren, Hormone, koloniestimulierende Faktoren, Fusionsproteine, Antisense-Oligonukleotide, Trefoil-Peptide, immunostimulierende [ISS] DNS) bei chronisch-entzündlichen Darmerkrankungen. Die Daten sowohl zu etablierten biologischen Therapien als auch in Erprobung befindlicher Substanzen werden diskutiert. Probiotika finden kurze Erwähnung. Die besprochenen Daten lassen erwarten, dass Biologika eine wichtige Rolle bei der Behandlung chronisch-entzündlicher Darmerkrankungen in naher Zukunft spielen werden.

Abstract

Biological therapies in inflammatory bowel disease reflect the exponential advancement in understanding the human intestinal immune system and particularly the biology of intestinal inflammation during the past decade. The better understanding of the mechanisms of inflammatory bowel disease has evolved from desriptive clinical data and genetically engineered animal models. It led to great interest in the evaluation of a variety of new therapeutic agents with novel actions. This review will discuss the mechanisms of biologicals (antibodies against pro-inflammatory cytokines, T cell antibodies, anti-inflammtory cytokines, adhesion molecule blockers, growth factors, hormones, colony stimulating factors, fusion proteins, anti-sense oligonucleotides, trefoil peptides, immunostimulatory [ISS] DNA) used in the treatment of inflammatory bowel disease and summarizes the available data on established biologic therapies as well as investigational agents and briefly touch on probiotics. Based on the data discussed, it seems that biologicals will play an important role in managing inflammatory bowel disease in the near future.

Schlüsselwörter

Morbus Crohn - Colitis ulcerosa - Antikörper - Immunsuppressiva - Zytokine - Probiotika

Key words

Crohn’s disease - ulcerative colitis - antibody - immunosuppressive therapy - cytokines - probiotics

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