Dtsch Med Wochenschr 2018; 113(13): 953-959
DOI: 10.1055/a-0538-3671
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© Georg Thieme Verlag KG Stuttgart · New York

Chronisch entzündliche Darmerkrankungen: Neue Therapieformen

Crohn’s Disease – New Therapies
Thomas Klag
,
Jan Wehkamp
Further Information

Publication History

Publication Date:
04 July 2018 (online)

Abstract

New promising treatment options for chronic inflammatory bowel diseases, confirm the expanded pathophysiological understanding in terms of the interactions of the gastrointestinal microbiome with the adaptive and innate immune response and barrier protection. Therefore, these interrelations are focus of research and therapeutic strategies. The following review will give insights into the pathomechanisms, current treatment options and future developments.

Vielversprechende neue Therapieansätze in der Behandlung chronisch entzündlicher Darmerkrankungen rücken die Pathophysiologie im Hinblick auf die Wechselwirkungen des gastrointestinalen Mikrobioms mit der adaptiven und angeborenen Immunantwort und Barriere-Sicherung zunehmend in den Fokus der Therapieforschung. Der folgende Beitrag gibt einen Einblick in die Pathomechanismen, aktuelle Behandlungsoptionen und zukünftige Entwicklungen.

 
  • Literatur

  • 1 Stange EF, Wehkamp J. Recent advances in understanding and managing Crohn’s disease. F1000Res 2016; 5: 2896 . doi:10.12688/f1000research.9890.1
  • 2 Ostaff MJ, Stange EF, Wehkamp J. Antimicrobial peptides and gut microbiota in homeostasis and pathology. EMBO Mol Med 2013; 5: 1465-1483 . doi:10.1002/emmm.201201773
  • 3 Martini E, Krug SM, Siegmund B. et al. Mend Your Fences: The Epithelial Barrier and its Relationship With Mucosal Immunity in Inflammatory Bowel Disease. Cell Mol Gastroenterol Hepatol 2017; 4: 33-46 . doi:10.1016/j.jcmgh.2017.03.007
  • 4 Schreiber S, Rosenstiel P, Albrecht M. et al. Genetics of Crohn disease, an archetypal inflammatory barrier disease. Nat Rev Gene 2005; 6: 376-388
  • 5 Jostins L, Ripke S, Weersma RK. et al. Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease. Nature 2012; 491: 119-124 . doi:10.1038/nature11582
  • 6 Stange EF. Improvement of a “Leaky” Intestinal Barrier. Dig Dis 2017; 35: 21-24 . doi:10.1159/000449078
  • 7 Nuding S, Fellermann K, Wehkamp J. et al. Reduced mucosal antimicrobial activity in Crohn’s disease of the colon. Gut 2007; 56 (09) 1240-1247
  • 8 Courth LF, Ostaff MJ, Mailänder-Sánchez D. et al. Crohn’s disease-derived monocytes fail to induce Paneth cell defensins. Proc Natl Acad Sci U S A 2015; 112: 14000-14005 . doi:10.1073/pnas.1510084112
  • 9 Swidsinski A, Ladhoff A, Pernthaler A. et al. Mucosal flora in inflammatory bowel disease. Gastroenterology 2002; 122: 44-54
  • 10 Wehkamp J, Götz M, Herrlinger K. et al. Inflammatory Bowel Disease. Dtsch Arztebl Int 2016; 113: 72-82 . doi:10.3238/arztebl.2016.0072
  • 11 Duijvestein M, Battat R, Vande Casteele N. et al. Novel Therapies and Treatment Strategies for Patients with Inflammatory Bowel Disease. Curr Treat Options Gastroenterol 2018; 16 (01) 129-146 . doi:10.1007/s11938-018-0175-1
  • 12 Klag T, Goetz M, Stange EF. Medical Therapy of Perianal Crohn’s Disease. Viszeralmedizin 2015; 31: 265-272 . doi:10.1159/000434664
  • 13 Hindryckx P, Vande Casteele N, Novak G. et al. The Expanding Therapeutic Armamentarium for Inflammatory Bowel Disease: How to Choose the Right Drug[s] for Our Patients?. Journal of Crohn’s and Colitis 2018; 12: 105-119 . doi:10.1093/ecco-jcc/jjx117
  • 14 Pelczar P, Witkowski M, Perez LG. et al. A pathogenic role for T cell-derived IL-22BP in inflammatory bowel disease. Science 2016; 354: 358-362
  • 15 Engel T, Ungar B, Yung DE. et al. Vedolizumab in IBD–Lessons From Real-world Experience: A Systematic Review and Pooled Analysis. J Crohns Colitis 2018; 12 (02) 245-257 . doi:10.1093/ecco-jcc/jjx143
  • 16 Saman S, Klag T, Wendler J. et al. P489 Clinical experience with ustekinumab in selected Crohn’s disease patients. J Crohns Colitis 2018; 12 (Suppl. 01) 352-353
  • 17 Kruis W, Fric P, Pokrotnieks J. et al. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut 2004; 53: 1617-1623
  • 18 Derwa Y, Gracie DJ, Hamlin PJ. et al. Systematic review with meta-analysis: the efficacy of probiotics in inflammatory bowel disease. Aliment Pharmacol Ther 2017; 46: 389-400 . doi:10.1111/apt.14203
  • 19 Stremmel W, Gauss A. Lecithin as a therapeutic agent in ulcerative colitis. Dig Dis 2013; 31: 388-390 . doi:10.1159/000354707
  • 20 Allegretti J, Eysenbach LM, El-Nachef N. et al. The Current Landscape and Lessons from Fecal Microbiota Transplantation for Inflammatory Bowel Disease: Past, Present, and Future. Inflamm Bowel Dis 2017; 23: 1710-1717 . doi:10.1097/MIB.0000000000001247
  • 21 Koeninger L, Armbruster N, Hu Z. et al. P851 Oral delivery of Human β-defensin 2 is reversibly increasing microbiome diversity and is effective in the treatment of experimental colitis. J Crohns Colitis 2018; 12 (Suppl. 01) 547
  • 22 Klag T, Mazurak N, Fantasia L. et al. High Demand for Psychotherapy in Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis 2017; 23: 1796-1802 . doi:10.1097/MIB.0000000000001216
  • 23 Malek NP. Personalization in the medicine of the future: Opportunities and risks. Internist (Berl) 2017; 58: 650-656 . doi:10.1007/s00108-017-0265-5
  • 24 de Jong MJ, van der Meulen-de Jong AE, Romberg-Camps MJ. et al. Telemedicine for management of inflammatory bowel disease (myIBDcoach): a pragmatic, multicentre, randomised controlled trial. Lancet 2017; 390: 959-968 . doi:10.1016/S0140-6736(17)31327-2