Immunotherapy for ulcerative colitis: targeting innate and adaptive immune responses for better clinical outcomes

Abstract Background Ulcerative colitis (UC) is a subtype of inflammatory bowel disease (IBD), characterized by chronic and recurrent inflammation of the colonic tract. This condition is marked by dysregulated immune responses, leading to sustained intestinal inflammation. Despite the efficacy of current treatments, there remains a critical need for more targeted and effective interventions. Main text Immunotherapy, which involves modulating the immune system to treat diseases, has emerged as a promising strategy for managing UC. Both innate and adaptive immunotherapies have shown considerable potential in treating colitis. Innate immunotherapies target the body’s first line of defense, offering an appealing option for colitis treatment by addressing components like macrophages and dendritic cells. Conversely, adaptive immunotherapies focus on specific immune cell subsets, such as T-cells, which are crucial in the pathogenesis of colitis. These therapies aim to modulate the abnormal immune response to reduce immuno-inflammation. Various forms of immunotherapies, including monoclonal antibodies, small molecules, and cellular therapies, have been extensively studied for their effectiveness in treating colitis and shown encouraging results. Monoclonal antibodies have been particularly promising, offering targeted action against specific components of the immune response. Small molecule therapies provide another avenue by modulating signaling pathways involved in inflammation. Cellular therapies, including stem cell treatments, represent an innovative approach, potentially offering long-term benefits by repairing damaged tissues and restoring immune balance. Conclusion This review offers a comprehensive overview of the current landscape of innate and adaptive immunotherapies for the treatment of UC. It details their mechanisms of action, potential benefits, and limitations. Overall, the significant promise of these therapies in combating colitis is underscored, highlighting their continued development and utilization in UC treatment. The potential of combining innate and adaptive immunotherapies could represent a dynamic duo in treating this debilitating condition, ultimately improving patient outcomes and quality of life. Graphical abstract