Cytokines in inflammatory bowel disease

Abstract

Erroneous communication between the innate and adaptive immune systems through cytokines results in exaggerated or attenuated immune response. It is not known whether the pathologic immune response in inflammatory bowel disease has its origin in a dysbalance of pro- and anti-inflammatory cytokine release or whether it is secondary in subsequence of a defective intestinal barrier or the destructive power of aggressive microbiota in the gut lumen. Many cytokines have been found upregulated in patients with inflammatory bowel diseases in correlation with disease activity. A central role seem to play cytokines that coordinate the T helper cell response. Although big scientific efforts have been made until today, only TNF blockers reached the clinical routine and many anti-cytokine strategies were only effective in rodent models of colitis. This chapter gives an overview about relevant pathomechanisms in mucosal immunology of the gut and focuses on the key cytokines that have been identified as targets for novel therapeutic strategies in human IBD.