Synergy of Transforming Growth Factor Beta 1 and All Trans Retinoic Acid in the Treatment of Inflammatory Bowel Disease: Role of Regulatory T cells.

Three groups of conventional therapies include salicylates, immunosuppressants and antibiotics. Yet relief is often shortlived and comes with significant side effects. 80% and 45% of CD and UC patients (Respectively) will still require surgery [16]. Biological response modifiers or ‘biologics’, macromolecules that target inflammatory lymphocytes or the cytokines they produce [7], have more recently emerged as another highly effective therapeutic class. In 1998, the FDA approved infliximab, with a high response rate, significant mucosal and fistula healing and long-term remissions in Crohn’s disease. Other biologics targeting p40, p19, IL-12, IL-17 and anti-alpha 4 integrin [7, 8] are either marketed or in various development stages. However as many as 30% of patients will not respond to biologics and half of those who initially respond, will relapse within a year. None have significant impact on surgical intervention rates [9].