Blocking the Differentiation and Amplification of Th17 cells
The innate immune cells, like DC (dendritic cells) and macrophages, and their cytokines, such as IL-1β. IL-6,IL-21,and IL-23, play a key role in differentiation and proliferation of TH17 cells; the use of neutralizing monoclonal antibodies for these cytokines or the antagonism of their receptors might be reasonable strategies for the treatment of intestinal disorders.
Fina, et al.  said that the blockade of IL-21R by the administration of IL-21R/Fc attenuates inflammation in mice and also said that neutralization of IL-21 by an antibody reduced IL-17 secretion by lamina propria lymphocytes isolated from intestinal inflammatory diseases. Similarly, neutralizing IL-21 antibody to mice with dextran-sodium-sulfate-induced colitis decreased the colonic T-cell infiltrate and the production of IL-6 and Il-17A in the inflamed colonic tissue. Recently the use of monoclonal antibody against ustekinumab and their success in inflammatory diseases might be due to their ability to simultaneously inhibit TH1 and TH17 cells: both of them are clearly implicated in intestinal inflammatory disorders.
Inhibition and/or Neutralization of TH17 cytokines
Zhang, et al.  reported that IL-17R knockout mice were significantly protected against colonic inflammation when compared to wild–type mice, and also stated that the over expression of IL-17A IgG1 fusion protein significantly attenuated colonic inflammation after acute trinitrobenzene-sulphonic-acid-induced colitis. As a contrasting result has been obtained in the human studies, such as a human anti-IL17A antibody failing to show any beneficial effect in intestinal inflammatory patients, now the studies are focused on evaluating a combined IL-17A and IL-17F blockade as a potential strategy for intestinal inflammatory therapy. Fitzpatrick, et al.  used vidofludimus, a novel oral immunomodulatory drug that inhibits dihyroorotate dehydrogenase and lymphocyte proliferation; the study showed the reduced expression of IL-17A and IL-17F, through the inhibition of STAT3 and nuclear factor-ᶄB activation. While considering the Th17 plasticity, the Th17 cells lose their ability to secrete the IL-17A and turn into IFN-α producers. They express a high level of aryl hydrocarbon receptor (AhR), a transcription factor expressed in the vertebrate cells, which mediates the range of the cellular events in response to different ligands including derivatives of tryptophan, such as 6-formylindolo (3,2-b) carbazole (Ficz). Activation of AhR results in enhanced production of IL-22, together with the reduction of Th1 and Th2 cytokines, as reported by Veldhoen, et al. .
Inhibition of TH17 cell specific transcription factors
Veldhoen  reported that the pharmacological target was the transcription factors RORӯt and STAT3, which control the TH17 polarization and function. Others proposed that the beneficial effects exerted by mesenchymal stem cells in experimental colitis can be associated with a down regulation of both TH1-TH17 driven autoimmune and inflammatory responses derived from the inhibition of RORӯt activity, together with the activation of CD4(+)CD25(+)Foxp3(+)Treg cells. Recently Fitzpatrick & Ulanovsky  described synthetic triterpenoids, dual small molecule inhibitors of NF-ᵏB and STAT3, which may also have potential benefits in intestinal inflammation.
Although much progress has been made in revealing the role of TH17 cells during intestinal inflammation, there is still lot to be learned. Therefore, a better understanding of this novel agent could lead to development of effective biological agents for intestinal inflammatory diseases.
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