Expert Review of Clinical Immunology,
Journal Year:
2023,
Volume and Issue:
20(3), P. 277 - 290
Published: Dec. 7, 2023
Introduction
Ulcerative
colitis
(UC)
is
a
chronic
inflammatory
bowel
disease
with
significant
health-care
burden
worldwide.
While
medical
therapy
aims
to
induce
and
maintain
remission,
optimal
management
of
mild
moderate
UC
remains
challenging
due
heterogeneity
in
severity
classifications
non-standardized
approaches.
This
comprehensive
review
summarizes
current
evidence
knowledge
gaps
optimize
clinical
decision-making
patients
UC.
JAMA,
Journal Year:
2024,
Volume and Issue:
332(11), P. 881 - 881
Published: July 22, 2024
Importance
The
clinical
effects
of
risankizumab
(a
monoclonal
antibody
that
selectively
targets
the
p19
subunit
IL-23)
for
treatment
ulcerative
colitis
are
unknown.
Objective
To
evaluate
efficacy
and
safety
when
administered
as
an
induction
a
maintenance
therapy
patients
with
colitis.
Design,
Setting,
Participants
Two
phase
3
randomized
trials
were
conducted.
trial
was
conducted
at
261
centers
(in
41
countries)
enrolled
977
from
November
5,
2020,
to
August
4,
2022
(final
follow-up
on
May
16,
2023).
238
37
754
28,
2018,
March
30,
April
11,
Eligible
had
moderately
severely
active
colitis;
history
intolerance
or
inadequate
response
1
more
conventional
therapies,
advanced
both
types
therapies;
no
prior
exposure
risankizumab.
Interventions
For
trial,
2:1
receive
1200
mg
placebo
intravenously
weeks
0,
8.
(determined
using
adapted
Mayo
score)
after
intravenous
1:1:1
subcutaneous
180
360
(no
longer
receiving
risankizumab)
every
8
52
weeks.
Main
Outcomes
Measures
primary
outcome
remission
(stool
frequency
score
≤1
not
greater
than
baseline,
rectal
bleeding
endoscopic
subscore
without
friability)
week
12
trial.
Results
Among
975
analyzed
in
(aged
42.1
[SD,
13.8]
years;
586/973
[60.1%]
male;
677
[69.6%]
White),
rates
132/650
(20.3%)
20/325
(6.2%)
(adjusted
between-group
difference,
14.0%
[95%
CI,
10.0%-18.0%],
P
<
.001).
548
40.9
14.0]
313
[57.1%]
407
[74.3%]
72/179
(40.2%)
risankizumab,
70/186
(37.6%)
46/183
(25.1%)
difference
vs
placebo,
16.3%
[97.5%
6.1%-26.6%],
.001;
adjusted
14.2%
4.0%-24.5%],
=
.002).
No
new
risks
detected
groups.
Conclusion
Relevance
Compared
improved
Further
study
is
needed
identify
benefits
beyond
52-week
follow-up.
Trial
Registration
ClinicalTrials.gov
Identifiers:
NCT03398148
NCT03398135
International Journal of Molecular Sciences,
Journal Year:
2025,
Volume and Issue:
26(2), P. 575 - 575
Published: Jan. 11, 2025
Inflammatory
bowel
disease
(IBD),
encompassing
Crohn's
and
ulcerative
colitis,
involves
chronic
inflammation
of
the
gastrointestinal
tract.
Current
immune-modulating
therapies
are
insufficient
for
30-50%
patients
or
cause
significant
side
effects,
emphasizing
need
new
treatments.
Targeting
innate
immune
system
enhancing
drug
delivery
to
inflamed
gut
regions
promising
strategies.
Neutrophils
play
a
central
role
in
IBD
by
releasing
reactive
oxygen
species
(ROS)
neutrophil
extracellular
traps
(NETs)
-DNA-based
structures
with
cytotoxic
proteins-that
contribute
mucosal
damage
inflammation.
Recent
studies
linking
ROS
production,
DNA
repair,
NET
formation
have
identified
NETs
as
potential
therapeutic
targets,
preclinical
models
showing
positive
outcomes
from
inhibition.
Innovative
oral
systems
designed
target
directly-without
systemic
absorption-could
improve
treatment
precision
reduce
effects.
Advanced
formulations
utilize
properties
such
particle
size,
surface
modifications,
ROS-triggered
release
selectively
distal
ileum
colon.
A
dual
strategy
that
combines
deeper
understanding
pathophysiology
identify
inflammation-related
targets
advanced
may
offer
promise.
For
instance,
pairing
inhibition
ROS-responsive
nanocarriers
could
enhance
efficacy,
though
further
research
is
needed.
This
synergistic
approach
has
greatly
patients.
Molecular Metabolism,
Journal Year:
2024,
Volume and Issue:
84, P. 101944 - 101944
Published: April 18, 2024
High-fat
diet
(HFD)
has
long
been
recognized
as
risk
factors
for
the
development
and
progression
of
ulcerative
colitis
(UC),
but
exact
mechanism
remained
elusive.
Here,
HFD
increased
intestinal
deoxycholic
acid
(DCA)
levels,
DCA
further
exacerbated
colonic
inflammation.
Transcriptome
analysis
revealed
that
triggered
ferroptosis
pathway
in
mice.
Mechanistically,
upregulated
hypoxia-inducible
factor-2α
(HIF-2α)
divalent
metal
transporter-1
(DMT1)
expression,
causing
ferrous
ions
accumulation
epithelial
cells,
which
was
reversed
by
inhibitor
ferrostatin-1.
failed
to
promote
intestine-specific
HIF-2α-null
Notably,
byak-angelicin
inhibited
DCA-induced
pro-inflammatory
pro-ferroptotic
effects
through
blocking
up-regulation
HIF-2α
DCA.
Moreover,
fat
intake
positively
correlated
with
disease
activity
UC
patients
consuming
HFD,
being
more
pronounced.
Collectively,
our
findings
demonstrated
inflammation
promoting
DCA-mediated
ferroptosis,
providing
new
insights
into
diet-related
bile
dysregulation
UC.
The Lancet. Gastroenterology & hepatology,
Journal Year:
2024,
Volume and Issue:
9(11), P. 1030 - 1040
Published: Sept. 20, 2024
Randomised
placebo-controlled
trials
for
the
induction
of
inflammatory
bowel
disease
(IBD)
remission
involve
potential
harms
to
those
receiving
placebo.
Whether
these
are
also
apparent
with
placebo
during
maintenance
in
IBD
is
unclear.
We
aimed
examine
associated
licensed
biologics
and
small
molecules
ulcerative
colitis
luminal
Crohn's
a
meta-analysis.
Journal of Clinical Medicine,
Journal Year:
2025,
Volume and Issue:
14(2), P. 333 - 333
Published: Jan. 8, 2025
Inflammatory
bowel
diseases
(IBDs),
encompassing
Ulcerative
Colitis
(UC)
and
Crohn's
Disease
(CD),
are
chronic
inflammatory
disorders
affecting
the
gastrointestinal
tract.
The
association
between
IBD
colorectal
cancer
(CRC)
is
well-documented.
Multiple
factors
have
been
identified
as
contributors
to
risk
of
developing
CRC
in
patients
with
IBD,
including
duration
disease,
disease
extension,
family
history
CRC,
co-existance
primary
sclerosing
cholangitis
(PSC),
potentially
presence
post-inflammatory
polyps
(PIPs).
PIPs,
often
referred
pseudopolyps,
polypoid
structures
that
emerge
a
result
severe
mucosal
inflammation.
While
their
has
linked
greater
severity,
role
PIPs
increasing
remains
controversial.
Increasing
evidence
suggests
an
(PIPs)
neoplasia,
serving
indicator
this
through
enhanced
may
also
be
distinct
patient
phenotype,
other
known
factors.
More
recent
studies
suggest
burden
(characterized
by
high
number
or
large
polyps)
important.
However,
inconsistent,
some
showing
no
clear
after
adjusting
for
factors,
histological
In
contrast,
data
low
rate
malignant
transformation
themselves.
This
narrative
review
aims
summarize
latest
regarding
relationship
focus
on
UC.
serve
markers
higher
severity
inflammation,
direct
contribution
unclear.
Further
research
needed
explore
carcinogenic
pathways
better
understand
development.
Journal of Crohn s and Colitis,
Journal Year:
2025,
Volume and Issue:
unknown
Published: Jan. 10, 2025
Abstract
Background
and
Aims
Treating
ulcerative
colitis
(UC)
in
patients
with
prior
advanced
therapy
(AT)
exposure
may
be
challenging.
We
report
the
efficacy
safety
of
risankizumab,
a
monoclonal
interleukin
23p19
antibody,
UC
inadequate
response
or
intolerance
to
AT
(AT-IR).
Methods
In
12-week
phase
3
INSPIRE
induction
study,
were
randomized
intravenous
risankizumab
1200
mg
placebo.
Clinical
responders
subcutaneous
180
mg,
360
placebo
(risankizumab
withdrawal)
52-week
COMMAND
maintenance
study.
This
post
hoc
analysis
assessed
outcomes
by
AT-IR
status,
number,
mechanism
action.
included
biologics,
Janus
kinase
inhibitors,
sphingosine-1-phosphate
receptor
modulators.
Results
Efficacy
analyses
472
Non-AT-IR
503
(induction),
137
411
(maintenance).
More
achieved
clinical
remission
per
Adapted
Mayo
score
versus
at
week
12
(Non-AT-IR,
29.7%
8.4%,
nominal
P
<
.0001;
AT-IR,
11.4%
4.3%,
=
.0083);
consistent
(withdrawal)
52
(NonAT-IR,
50.9%
61.7%
31.1%,
.057
.0033,
respectively;
36.6%
29.5%
23.2%,
.0159
.2334,
respectively).
Risankizumab
had
increased
over
placebo,
regardless
number
action,
higher
rates
for
NonAT-IR
compared
AT-IR.
Safety
results
generally
comparable
both
maintenance.
Conclusion
was
effective
well
tolerated,
status.