Abstract |
The heterodimeric cytokines IL-12 and IL-23 play a key role in T helper cell and innate lymphocyte cell differentiation and expansion. They are composed of a shared p40 chain, which pairs with a p35 or p19 chain to form IL-12 and IL-23, respectively. Preclinical model systems have predicted an important role of the p40 chain in intestinal inflammation. Moreover, genome-wide association studies have revealed that variants of the gene encoding the IL-23 receptor, as well as the locus harboring the gene encoding the p40 chain, confer genetic risk for developing Crohn's disease (CD) and ulcerative colitis (UC). Two monoclonal antibodies neutralizing the p40 chain ( ustekinumab and briakinumab) and hence blocking both IL-12 and IL-23 activity, have been developed, which demonstrated clinical benefit in early phase trials, and hinted towards efficacy in a subpopulation of patients with CD who had failed prior anti-TNF antibody treatment. A dedicated phase 3 clinical trial of ustekinumab in patients suffering from moderate-to-severe CD who had previously failed anti-TNF antibody treatment indeed demonstrated a significant benefit over placebo for clinical response, but not remission, in this particularly difficult to treat patient population. Here we review the immunological and genetic background to anti- IL-12/IL-23-directed therapeutic strategies, and the lessons that can be learned from results of these and related clinical trials that tackle associated biological pathways.
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Authors | Lukas Niederreiter, Timon Erik Adolph, Arthur Kaser |
Journal | Current drug targets
(Curr Drug Targets)
Vol. 14
Issue 12
Pg. 1379-84
(Nov 2013)
ISSN: 1873-5592 [Electronic] United Arab Emirates |
PMID | 24138637
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Humanized
- Interleukin-12 Subunit p40
- Interleukin-23 Subunit p19
- briakinumab
- Ustekinumab
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Topics |
- Animals
- Antibodies, Monoclonal
(pharmacology, therapeutic use)
- Antibodies, Monoclonal, Humanized
(pharmacology, therapeutic use)
- Clinical Trials as Topic
- Crohn Disease
(drug therapy, genetics, immunology)
- Disease Models, Animal
- Humans
- Immunity, Innate
- Interleukin-12 Subunit p40
(antagonists & inhibitors, immunology)
- Interleukin-23 Subunit p19
(antagonists & inhibitors, immunology)
- Ustekinumab
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