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Alternative Drug Delivery Approaches for the Therapy of Inflammatory Bowel Disease

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Alternative Drug Delivery Approaches for the Therapy of Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) is an incurable chronic intestinal disorder that has been linked to significant morbidity and productivity loss worldwide. It’s caused by genetic predisposition, environmental factors, mucosal barrier dysfunction and dysregulated immune responses. While many therapies have been developed for treating IBD, they remain insufficient for most patients. Patients living with IBD often experience relapsing symptoms, frequent visits to their physician, as well as financial strain on both themselves and healthcare systems.

Targeted pharmacologic therapy targeting different pathways has revolutionized the treatment of IBD, including small molecules, biologics and oral small molecules. Unfortunately, there remain several challenges that need to be addressed in order to increase their efficacy and boost patient compliance with these treatments.

Safety issues remain a major obstacle in the development of new therapies for IBD, especially biologics. They have an increased potential for immunogenicity and side effects such as infections, malignancies, and metabolic disorders. Therefore, it’s essential to comprehend both the risks associated with various types of IBD drugs and their safety profile before determining if they are suitable for clinical use.

Alternative drug delivery approaches have become an integral part of IBD treatment and offer a promising opportunity to deliver drugs directly into the site of inflammation. Eukaryotic cells such as GM immune and red blood cells can serve as nanoparticle carriers, transporting therapeutics into inflamed tissue. Nanoparticle carriers encase drugs within nanoshells which improves their solubility, stability and release rate at the affected site. Furthermore, nanoparticles may be engineered to control molecular accumulation at these targeted locations which helps reduce systemic toxicity [24].

Apheresis therapies are another viable treatment option for IBD, involving the isolation of leukocytes from peripheral blood and their infusion into the gut. The primary goal is to reduce local inflammation and promote mucosal healing. These treatments have shown significant success with IBD patients, with their use increasing worldwide.

Cell and exosome therapies are two promising therapeutic options for IBD. Derived from natural sources, these treatments may have therapeutic potential by targeting specific pathogenic mechanisms. While they have shown promise in terms of encouraging mucosal healing and reducing relapse rates, further studies are necessary to establish their safety over long-term usage.

Biopharmaceuticals are the most frequently employed treatments for IBD, and can be divided into two categories: monoclonal antibodies and small molecule drugs. Monoclonal antibodies block various cytokine signaling and immune cell trafficking pathways like IL-1, IL-18 and TNF- receptors while targeting cell surface markers like a4b7 integrin or MAdCAM-1.

Etrolizumab, a humanized monoclonal antibody that blocks both a4b7 and aEb7 integrins, has been approved for treating ulcerative colitis (UC). The agent interferes with MAdCAM-1 interaction in the gut epithelium by stopping homed lymphocyte migration.

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