College of Public Health, Medical, and Veterinary Sciences (CPHMVS), James Cook University, Building E4, McGregor Rd, Smithfield, Cairns, QLD 4878, Australia.
Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Building E4, McGregor Rd, Smithfield, Cairns, QLD 4878, Australia.
Molecules. 2024 Aug 21;29(16):3954. doi: 10.3390/molecules29163954.
Inflammatory bowel disease (IBD) is a chronic, lifelong disorder characterized by inflammation of the gastrointestinal (GI) tract. The exact etiology of IBD remains incompletely understood due to its multifaceted nature, which includes genetic predisposition, environmental factors, and host immune response dysfunction. Currently, there is no cure for IBD. This review discusses the available treatment options and the challenges they present. Importantly, we examine emerging therapeutics, such as biologics and immunomodulators, that offer targeted treatment strategies for IBD. While many IBD patients do not respond adequately to most biologics, recent clinical trials combining biologics with small-molecule drugs (SMDs) have provided new insights into improving the IBD treatment landscape. Furthermore, numerous novel and specific therapeutic targets have been identified. The high cost of IBD drugs poses a significant barrier to treatment, but this challenge may be alleviated with the development of more affordable biosimilars. Additionally, emerging point-of-care protein biomarkers from serum and plasma are showing potential for enhancing the precision of IBD diagnosis and prognosis. Several natural products (NPs), including crude extracts, small molecules, and peptides, have demonstrated promising anti-inflammatory activity in high-throughput screening (HTS) systems and advanced artificial intelligence (AI)-assisted platforms, such as molecular docking and ADMET prediction. These platforms are advancing the search for alternative IBD therapies derived from natural sources, potentially leading to more affordable and safer treatment options with fewer side effects.
炎症性肠病（IBD）是一种慢性、终身性疾病，其特征为胃肠道（GI）炎症。由于其多方面的性质，包括遗传易感性、环境因素和宿主免疫反应功能障碍，IBD 的确切病因仍不完全清楚。目前，IBD 尚无治愈方法。本文讨论了现有的治疗选择及其面临的挑战。重要的是，我们研究了新兴的治疗药物，如生物制剂和免疫调节剂，它们为 IBD 提供了靶向治疗策略。虽然许多 IBD 患者对大多数生物制剂的反应不充分，但最近将生物制剂与小分子药物（SMD）联合使用的临床试验为改善 IBD 治疗前景提供了新的见解。此外，已经确定了许多新的和特定的治疗靶点。IBD 药物的高成本是治疗的一个重大障碍，但随着更经济实惠的生物类似药的开发，这一挑战可能会得到缓解。此外，来自血清和血浆的新兴即时护理蛋白生物标志物在提高 IBD 诊断和预后的准确性方面显示出潜力。几种天然产物（NPs），包括粗提取物、小分子和肽，在高通量筛选（HTS）系统和先进的人工智能（AI）辅助平台（如分子对接和 ADMET 预测）中显示出有希望的抗炎活性。这些平台正在推进从天然来源寻找替代 IBD 疗法的研究，可能会带来更经济实惠、更安全、副作用更少的治疗选择。
