From single-target to cellular niche targeting in Crohn's disease: intercepting bad communications.

EBioMedicine

The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, Hess CSM Building Room 8-201, New York, NY 10029, USA.

Published: December 2021


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Article Abstract

The mainstay of moderate to severe Crohn's disease (CD), anti-TNF treatment, shows no clinical benefit in ∼40% of patients, likely due to incomplete cellular targeting and delayed treatment institution. While single-target therapeutics have been highly effective for some CD patients, substantial limitations with respect to safety, efficacy, and long-term, complete remission remain. Deconvolution of the cellular and molecular circuitry of tissue lesions underscores the importance of combinatorial strategies targeting cellular niches. This review aims to evaluate current therapeutic approaches used to manage CD, and highlight recent advances to our cellular, genetic, and molecular understanding of mechanisms driving pathogenic niche activation in CD. We propose new frameworks outlining that combinatorial therapies, along with serial tissue sampling and studies guided by genetics and genomics, can advance on current treatment approaches and will inform newer strategies upon which we can move towards precision therapeutics in IBD.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601974PMC
http://dx.doi.org/10.1016/j.ebiom.2021.103690DOI Listing

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