The role of integrin antagonists in the treatment of inflammatory bowel disease

New and emerging therapies for acute and chronic graft versus host disease

Graft versus host disease (GVHD) remains a major cause of morbidity and mortality following allogeneic hematopoietic stem-cell transplantation (HSCT). Despite the use of prophylactic GVHD regimens, a significant proportion of transplant recipients will develop acute or chronic GVHD following HSCT. Corticosteroids are standard first-line therapy, but are only effective in roughly half of all cases with ~50% of patients going on to develop steroid-refractory disease, which increases the risk of nonrelapse mortality. While progress has been made with improvements in survival outcomes over time, corticosteroids are associated with significant toxicities, and many currently available salvage therapies are associated with increased immunosuppression, infectious complications, and potential loss of the graft versus leukemia (GVL) effect. Thus, there is an unmet need for development of newer treatment strategies for both acute and chronic GVHD to improve long-term post-transplant outcomes and quality of life for HSCT recipients. Here, we provide a concise review of major emerging therapies currently being studied in the treatment of acute and chronic GVHD.

Anti-inflammatory effects of Fagopyrum cymosum administered as a potential drug for ulcerative colitis

Fagopyrum cymosum (Trev.) Meisn (Fag), which belongs to the Polygonaceae family, has been widely used to treat inflammatory diseases. Previous studies have revealed that Fag components exhibit anti-inflammatory activities; however, their potential use in treating inflammatory bowel disease (IBD) has not been explored. In the present study, mice with 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis were used as a model of IBD. Fag extract was orally administered for 3 days following the induction of colitis and the conventional drug, salicylazosulfapyridine (SASP), was used as a control. The results revealed that Fag significantly ameliorated TNBS-induced body weight loss and colonic shortening in mice (P<0.05). Furthermore, Fag suppressed levels of proinflammatory cytokines and reduced macrophage infiltration into colonic tissues (P<0.05). To further verify the anti-inflammatory effects of Fag at the molecular level, a murine macrophage cell line, Raw264.7, was used. Nuclear translocation of nuclear factor (NF)-κB p65 and the phosphorylation of inhibitor of NF-κB (IκB) were assessed using western blotting. The results demonstrated that Fag inhibited the production of proinflammatory cytokines via inhibiting NF-κB p65 nuclear translocation and IκB phosphorylation (P<0.05). Furthermore, the clinical study results revealed that Fag had significantly fewer side effects (P<0.05) and served as a better anti-inflammatory drug for ulcerative colitis compared with SASP.

Combination Therapy of PEG-HM-3 and Methotrexate Retards Adjuvant-Induced Arthritis

At present, the early phenomenon of inflammatory angiogenesis is rarely studied in Rheumatoid arthritis (RA). Previous research found that PEG-HM-3, an integrin inhibitor, possessed anti-angiogenesis and anti-rheumatic activity. In this study, the advantages of inhibiting angiogenesis and immune cell adhesion and migration, as well as the benefits of anti-arthritis effects, were evaluated using a combination of PEG-HM-3 and methotrexate (MTX). In vitro, spleen cell proliferation and the levels of tumor necrosis factor α (TNF-α) in macrophage supernatant were assessed. Hind paw edema, arthritis index, clinical score, body weight and immunohistochemistry (IHC) of the spleen, thymus, and joint cavity were evaluated in vivo in adjuvant-induced arthritis rats. Joints of the left hind paws were imaged by X-ray. The expression of the toll-like receptor 4 (TLR-4) protein was assessed in lipopolysaccharide (LPS)-induced synoviocytes. PEG-HM-3 combined with MTX significantly reduced primary and secondary swelling of the hind paws, the arthritis index, the clinical score and bone erosion. The results of IHC showed that the levels of interleukin-6 (IL-6) in spleens and the levels of TNF-α, CD31 (cluster of differentiation 31), and CD105 in the joint cavity were decreased. The body weight of rats was maintained during combination therapy. Ankle cavity integrity, and bone erosion and deformity were improved in combination treatment. The expression of TLR-4 was significantly reduced with combination treatment in rat synoviocytes. Co-suppression of both inflammation and angiogenesis in arthritis was achieved in this design with combination therapy. The activity of nuclear transcription factor (NF-κB) and the expression of inflammatory factors were down regulated via integrin αvβ₃ and TLR-4 signaling pathways. In the future, the application of this combination can be a candidate in early and mid-term RA therapy.