Inflammatory bowel diseases (IBD) are characterized by a persistent recruitment of large quantities of leucocytes
from the blood to the gut mucosa. Adhesion molecules, such as integrins and their ligands, are the main players in
this complex process. Leucocyte traffic control using a specific integrin inhibitors, such as natalizumab, has been plagued
by severe systemic effects. The α4β7 – integrin and its ligand, the MadCAM-1, have been of special interest, since they are
found exclusively on the gut-homing lymphocyte subpopulations and in the intestinal mucosa respectively. It follows that
inhibition of such molecules should offer gut-specific immunosuppression, without the systemic effects of aspecific integrin-
antagonists. We review the role of vedolizumab, a humanized antibody against the α4β7 – integrin, in both ulcerative
colitis (UC) and Crohn's disease (CD). Results from clinical trials show that vedolizumab is effective in the induction
and maintenance of remission in active CD and UC and has a very good safety profile. These data allow to confidently
prospect that vedolizumab will be an important therapeutic option in the future of IBD treatment.
Keywords: Inflammatory bowel disease, Crohn’s disease, ulcerative colitis, α4β7 integrin, anti-integrins, adhesion molecules,
natalizumab, vedolizumab, etrolizumab, MAdCAM-1, CAM.
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