Anti-integrin therapy in inflammatory bowel disease: acomprehensive review

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a chronic immune-mediated disorder of the gastrointestinal tract characterized by episodes of inflammation and ongoing tissue damage. Standard medical treatments, such as corticosteroids, immunomodulators, and tumor necrosis factor (TNF) inhibitors, have improved patient outcomes but are limited by incomplete responses, systemic immunosuppression, and side effects. Anti-integrin therapies offer a targeted method that specifically blocks leukocyte movement into the intestinal mucosa. Integrins are cell adhesion molecules that facilitate immune cell migration and tissue infiltration. By blocking the interaction between leukocyte integrins and endothelial cell adhesion molecules, anti-integrin agents prevent inflammatory cells from entering the gastrointestinal tract. Currently approved anti-integrin drugs for IBD include natalizumab and vedolizumab, with newer options like etrolizumab under research. These medications demonstrate significant success in inducing and maintaining remission in patients with moderate to severe IBD. Notably, gut-selective agents such as vedolizumab provide enhanced safety by reducing systemic immunosuppression. This review explores the pharmacological mechanisms, pharmacokinetics, clinical effectiveness, safety profiles, and emerging therapeutic roles of anti-integrin therapies in inflammatory bowel disease.