Therapeutic value ofalpha-4 integrin blockade in inflammatory bowel disease:the role of natalizumab

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Abstract
Lymphocyte infiltration into the intestinal tract in Crohn's disease is mediated by the interaction between alpha(4) integrin, expressed on lymphocytes, and its ligand mucosal vascular addressin cell-adhesion molecule-1 (MADCAM-1), expressed on the endothelial cells of the microvasculature in inflamed intestinal tract. Natalizumab, a recombinant, humanised monoclonal antibody against alpha(4) integrin was effective in Crohn's disease in a Phase II, randomised, controlled trial. The highest response rate and remission rates were 71 and 44% at 6 weeks, respectively, after two infusions of 3 mg of natalizumab administered 4 weeks apart. Natalizumab was well-tolerated in this study. The Phase III trial results are awaited.