Franco Scaldaferri
Italy
Review Article
Emerging Mechanisms of Action and Loss of Response to Infliximab in Ibd: A Broader Picture
Author(s): Franco Scaldaferri, Silvia Pecere, Daria D’Ambrosio, Stefano Bibbò, Valentina Petito, Loris Riccardo Lopetuso, Diego Currò, Marco Pizzoferrato, Gianluca Ianiro, Antonio Gasbarrini and Giovanni CammarotaFranco Scaldaferri, Silvia Pecere, Daria D’Ambrosio, Stefano Bibbò, Valentina Petito, Loris Riccardo Lopetuso, Diego Currò, Marco Pizzoferrato, Gianluca Ianiro, Antonio Gasbarrini and Giovanni Cammarota
Biologic drugs, as Infliximab (IFX), are widely used in inflammatory bowel disease (IBD). IFX is a chimeric monoclonal immunoglobulin directed against TNF-α and acting in IBD through several mechanisms of action. We divide these mechanisms into central and peripheral. Central mechanisms are considered effective at systemic level, like the reduction of plasmatic pro-inflammatory cytokines (TNF-α, IFN-γ), the promotion of apoptosis of inflammatory cells, the induction of T regulatory cells (FOXP3CD4+) and the modulation of cellular inflammatory pathways. Peripheral mechanisms could be considered acting at mucosal levels like normalization of endothelial functions, blockade of angiogenesis, restoring balance between matrix metalloproteinases (MMPs) and tissue inhibitors of matalloproteases (TIMPs). This classification could serve as solid gu.. View More»
