Unraveling the complexity of ulcerative colitis: insights into cytokine dysregulation and targeted therapies

Authors

  • Yuta Shimomori Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Hokkaido, Japan. Tel: +81-11-611-2111, Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu 879-5593, Oita, Japan. Tel: +81-97-586-4411 https://orcid.org/0009-0005-2261-3830
  • Yoshihiro Yokoyama Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Hokkaido, Japan. Tel: +81-11-611-2111 https://orcid.org/0000-0003-2434-1048
  • Hiroki Kurumi Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Hokkaido, Japan. Tel: +81-11-611-2111 https://orcid.org/0000-0002-2372-1631
  • Kotaro Akita Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Hokkaido, Japan. Tel: +81-11-611-2111 https://orcid.org/0009-0004-7002-673X
  • Tomoe Kazama Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Hokkaido, Japan. Tel: +81-11-611-2111
  • Yuki Hayashi Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Hokkaido, Japan. Tel: +81-11-611-2111 https://orcid.org/0000-0001-8680-404X
  • Kazuhiro Mizukami Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu 879-5593, Oita, Japan. Tel: +81-97-586-4411 https://orcid.org/0000-0002-3148-8884
  • Hiroshi Nakase Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Japan. Tel: +8111-611-2111, E-mail: hiropynakase@gmail.com https://orcid.org/0000-0003-2848-6586

DOI:

https://doi.org/10.17179/excli2025-8374

Keywords:

ulcerative colitis, cytokines, targeted therapy, innate immune cells, adapted immune cells

Abstract

Ulcerative colitis (UC) is a chronic or recurrent inflammatory disease of the large intestine. Although the causes of UC are insufficiently understood, a complex interaction of several factors, including genetic factors, environmental factors, and gut microbiota, influences the onset of UC. The pathophysiology of UC involves intestinal barrier dysfunction, abnormal immune responses, and dysregulation of cytokines. Cytokine-targeted therapies have been approved for the treatment of UC, with several targeted therapies being currently available. The induction response rates range from 47.8 % to 73 %, and we often experience difficult-to-treat cases. In this review, we outlined the abnormal immune response and cytokine regulation underlying the complex pathology of UC. Moreover, we summarized the mode of action and the effects at the cellular and genetic levels of targeted therapies. A deeper understanding of the pathophysiology of UC and the effects of treatment is essential for advancing personalized medicine, which remains a key, challenging goal in the future management of UC.

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Published

2025-06-06

How to Cite

Shimomori, Y., Yokoyama, Y., Kurumi, H., Akita, K., Kazama, T., Hayashi, Y., … Nakase, H. (2025). Unraveling the complexity of ulcerative colitis: insights into cytokine dysregulation and targeted therapies. EXCLI Journal, 24, 638–658. https://doi.org/10.17179/excli2025-8374

Issue

Vol. 24 (2025)

Section

Review articles

Categories

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Copyright (c) 2025 Yuta Shimomori, Yoshihiro Yokoyama, Hiroki Kurumi, Kotaro Akita, Tomoe Kazama, Yuki Hayashi, Kazuhiro Mizukami, Hiroshi Nakase

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