Targeting therapy in pediatric inflammatory bowel disease
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Progress in our understanding of the interaction between the environment and the immune system in disease pathogenesis has led to major advancements in the area of inflammatory bowel disease (IBD) therapeutics. Biotechnology is keeping pace with these scientific advances. Current therapies target the various elements of the inflammatory cascade implicated in the pathogenesis of IBD. The anti-inflammatory and immunomodulatory properties of the pharmacologic therapies used in IBD vary from actions that are extremely broad to those that are cellular or cytokine specific. Despite the various therapeutic options available for IBD patients, chosen therapies should be based on the overall treatment goal for individual patients. Therapeutics can be broadly categorized as induction therapies (goal to treat active disease) and maintenance therapies (goal to prevent relapse of disease). The modern thinking behind drug development is that IBD therapy should be disease modifying so to avoid complications and alter the long term natural history of disease. This review will cover both current and emerging agents and highlight the pathogenesis of IBD and how it relates to therapeutic targets.
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