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Review
. 2020 Jul 17;26(8):1131-1143.
doi: 10.1093/ibd/izaa045.

Resolution of Inflammation and Gut Repair in IBD: Translational Steps Towards Complete Mucosal Healing

Gwo-Tzer Ho  1 , Jennifer A Cartwright  1 , Emily J Thompson  1 , Calum C Bain  1 , Adriano G Rossi  1
Affiliations
Review

Resolution of Inflammation and Gut Repair in IBD: Translational Steps Towards Complete Mucosal Healing

Gwo-Tzer Ho et al. Inflamm Bowel Dis. .

Abstract

Despite significant recent therapeutic advances, complete mucosal healing remains a difficult treatment target for many patients with inflammatory bowel diseases (IBD) to achieve. Our review focuses on the translational concept of promoting resolution of inflammation and repair as a necessary adjunctive step to reach this goal. We explore the roles of inflammatory cell apoptosis and efferocytosis to promote resolution, the new knowledge of gut monocyte-macrophage populations and their secreted prorepair mediators, and the processes of gut epithelial repair and regeneration to bridge this gap. We discuss the need and rationale for this vision and the tangible steps toward integrating proresolution therapies in IBD.

Keywords: Crohn; inflammation; inflammatory bowel disease; mucosal healing; ulcerative colitis.

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Figures

FIGURE 1.
FIGURE 1.
From initiation to the development of the chronic nonresolving inflammatory milieu in the IBD gut mucosa. Main biologic treatments such as anti-integrins, anti-TNF, IL-23p40, and Janus kinase inhibitors block single factors to reduce inflammation. Potentiating factors in the red box. ATP indicates adenosine triphosphate; mtDNA, mitochondrial DNA.
FIGURE 2.
FIGURE 2.
Promoting resolution of inflammation in IBD. Key events and pathways that can be targeted to promote and accelerate resolution and repair following IBD treatment.
FIGURE 3.
FIGURE 3.
Therapeutic positioning of proresolution/repair approaches in IBD. Combined anti-inflammatory and proresolution therapy potential to significantly improve beyond current rates of complete mucosal healing in IBD.
See this image and copyright information in PMC

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