Category: immune_innate
Inflammatory bowel disease (Crohn's, UC) is driven by dysregulated mucosal immunity — TNF-α + IL-12/23 + IL-17 + α4β7 integrin trafficking + IL-23/Th17. Treatment escalates from local-acting (5-ASA — mesalamine, sulfasalazine in UC) to budesonide (ileal-targeted GR — covered in END-1) to systemic immunosuppression (thiopurines azathioprine + methotrexate — covered in ONC-3) to biologics (TNF-α: infliximab/adalimumab/golimumab/certolizumab; IL-12/23: ustekinumab; IL-23: risankizumab; integrin: vedolizumab — α4β7-selective gut-restricted; S1P modulator: ozanimod). Mesalamine + sulfasalazine (5-ASA prodrug release in colon) dominate maintenance for UC; the active 5-aminosalicylic acid is locally anti-inflammatory via PPAR-γ + NF-κB + COX inhibition.