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Anti-tumor necrosis factor therapy in inflammatory bowel disease
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This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.
This book is the 34th volume of the ongoing series ‘Frontiers of Gastrointestinal Research. It has 35 chapters dealing exclusively with anti-tumour necrosis factor (TNF) therapy in inflammatory bowel disease (IBD). The initial sections of the book comprehensively review the role of TNF in the pathogenesis of IBD, including its regulatory effect on epithelial function, macrophage and dendritic cell function, T cell function, barrier function, innate immune defense mechanisms, and adaptive immune mechanisms. This is followed by chapters that review how anti-TNF antibodies act to bind membrane bound TNF, to neutralize soluble TNF, and to regulate T cells and monocytes. The remaining two thirds of the book is of significant interest to clinicians and IBD physicians. The latter section is also comprehensive, dealing with screening prior to therapy, the problem of neutralizing antibodies and how this impacts treatment, and the role of measuring anti-TNF trough concentrations. Side effects of these agents on the skin, vascular sites and a lupus-like syndrome, are all covered in detail. The risks of longer term therapy including infections and haematologic malignancies are also discussed in detail. The use of anti-TNF therapies in specific diseases including Crohn's disease and ulcerative colitis, and their use in sub-groups of IBD, during breast feeding and prior to surgery are also discussed in detail. It is disappointing that there is no separate chapter available dealing with the specific antibodies, though the information is spread throughout the book. There is a small section on biosimilars which could have been more elaborate and discussed the biosimilars available in the market and the experience with these. Biosimilars are likely to make a high impact in years to come and an in depth discussion would have been appropriate.
Overall, this book seeks to be a comprehensive reference on this rather limited subject. It will be of use to all IBD researchers and physicians and is well worth a place in their libraries.
