2018 Volume 33 Issue 5 Pages 414-421
Inflammatory bowel disease (IBD) commonly occurs in young people, and the number of IBD patients is still increasing in Japan. Regarding the treatment of IBD, glucocorticosteroids (CSs), immunosuppressants, and biologics are used for the purpose of controlling excessive immune response. Although the therapeutic effect of CSs has been established, physicians always concern about adverse events related to long-term use of CSs. Additionally, treatment with anti-inflammatory cytokines has been expected, however, the efficacy of their systemic administration is not necessarily expected because of their short half-life. Drug delivery system (DDS) can in principle provide enhanced efficacy and/ or reduced toxicity of drugs. Until now, there have been various reports of therapeutic effects of DDS with genetically modified intestinal bacteria, that can produce anti-inflammatory substances, on IBD models. Previously, DDS with genetically modified intestinal bacteria producing interleukin-10 had been focused. Recently, reports on DDS with genetically modified intestinal bacteria producing proteins and other cytokines except IL-10 are increasing. On the other hand, further studies will be required to elucidate how kinds of intestinal bacteria and anti-inflammatory substances affect therapeutic efficacy in ameliorating intestinal inflammation. Additionally, to assess the safety of treatment with these DDS and the risk influencing environment will be necessary before clinical application.
