Abstract
Introduction.
Inflammatory bowel disease (IBD) is an autoimmune disease that presents with chronic inflammation of the intestinal tract. Based on previous reports, various factors are involved in the pathogenesis of IBD, including immune function based on genetic factors, environmental factors and the intestinal microbiota. Medical therapy is the mainstay of treatment, with 5-aminosalicylic acid (5-ASA), which has anti-inflammatory effects, and immunosuppressive drugs. We investigated treatment trends using data on all 44,328 patients diagnosed with IBD over a five-year period from April 2016 to March 2021 from the JMDC Claims Database, the largest epidemiological receipt database in Japan. As a result, 5-ASA and oral elemental nutrition (ED) therapy were extracted as the most frequent treatments.
IBD and regulatory T cells
5-ASA has been suggested to induce regulatory T cells (Treg) via aryl hydrocarbon receptors (AhR), in addition to existing anti-inflammatory mechanisms. Furthermore, the authors reported that 5-ASA is a direct ligand for AhR and its binding sites (Kubota et al., Pharmacol. 2022). Therefore, we also focused on AhR for ED therapy, which is frequently prescribed, and conducted various studies. As a result, an increase in blood IL-10, suppression of TNF-α and increase in splenic Treg were observed, in addition to a suppressive effect on intestinal inflammation. In this presentation, we would like to show that an immunological approach focusing on AhR can help to control the pathogenesis of IBD.
