The prospect of interleukin -23p19 inhibitors in precision treatment of Crohn's disease: mechanisms and clinical evidence
10.3760/cma.j.cn101480-20250426-00066
- VernacularTitle:白细胞介素-23p19抑制剂精准治疗克罗恩病的前景：机制与临床证据
- Author:
Yujing SUN
1
;
Xueliang SUN
;
Zhaozheng ZHANG
;
Hongyan ZHENG
;
Xiao YANG
;
Xingru CHEN
;
Ke WEN
Author Information
1. 南京中医药大学，南京 210023
- Publication Type:Journal Article
- Keywords:
Interleukin -23p19;
Risankizumab;
Mirikizumab;
Guselkumab
- From:
Chinese Journal of Inflammatory Bowel Diseases
2025;09(5):390-396
- CountryChina
- Language:Chinese
-
Abstract:
Interleukin- (IL) 23 drives pathogenic differentiation of Th17 cells via the JAK2-STAT3 signaling pathway, upregulates IL-17A/IL-22 expression, and disrupts intestinal barrier integrity, thereby playing a pivotal role in the pathogenesis of Crohn's disease (CD). IL-23p19 inhibitors—exemplified by risankizumab, mirikizumab, and guselkumab—precisely block this pathway. Key phase 3 trials have demonstrated their efficacy in CD, showing significant clinical benefits in patients refractory to conventional therapies or biologics, with no new safety signals identified. The ultimate treatment goal for CD is deep healing (mucosal-transmural-biochemical composite remission) as defined by STRIDE II. However, current evidence exhibits critical limitations: absence of head-to-head drug comparisons, insufficient data on biologic-experienced subpopulations, and heterogeneous follow-up durations leading to uncertainties in long-term safety. Future studies require standardized head-to-head trials with enhanced subgroup analyses to optimize precision therapeutics.
