Review
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 7, 2013; 19(25): 3931-3941
Published online Jul 7, 2013. doi: 10.3748/wjg.v19.i25.3931
Why interleukin-10 supplementation does not work in Crohn’s disease patients
Gareth J Marlow, Dominique van Gent, Lynnette R Ferguson
Gareth J Marlow, Dominique van Gent, Lynnette R Ferguson, Discipline of Nutrition, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand
Gareth J Marlow, Lynnette R Ferguson, Nutrigenomics New Zealand, The University of Auckland, Auckland 1142, New Zealand
Author contributions: All authors contributed equally to this paper.
Supported by The Ministry of Business, Innovation and Employment; Dutch Digestive Foundation
Correspondence to: Lynnette R Ferguson, Professor, Discipline of Nutrition, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. l.ferguson@auckland.ac.nz
Telephone: +64-9-9236372 Fax: +64-9-3035962
Received: February 28, 2013
Revised: April 18, 2013
Accepted: May 8, 2013
Published online: July 7, 2013
Processing time: 128 Days and 8.8 Hours
Abstract

Inflammatory bowel diseases (IBD) such as Crohn’s disease (CD) or ulcerative colitis are chronic intestinal disorders, which are on the increase in “Westernised” countries. IBD can be caused by both genetic and environmental factors. Interleukin-10 (IL-10) is an immunoregulatory cytokine that has been identified as being involved in several diseases including IBD. Studies have shown that polymorphisms in the promoter region reduce serum levels of IL-10 and this reduction has been associated with some forms of IBD. Mouse models have shown promising results with IL-10 supplementation, as such IL-10 supplementation has been touted as being a possible alternative treatment for CD in humans. Clinical trials have shown that recombinant human IL-10 is safe and well tolerated up to a dose of 8 μg/kg. However, to date, the results of the clinical trials have been disappointing. Although CD activity was reduced as measured by the CD activity index, IL-10 supplementation did not result in significantly reduced remission rates or clinical improvements when compared to placebo. This review discusses why IL-10 supplementation is not effective in CD patients currently and what can be addressed to potentially make IL-10 supplementation a more viable treatment option in the future. Based on the current research we conclude that IL-10 supplementation is not a one size fits all treatment and if the correct population of patients is chosen then IL-10 supplementation could be of benefit.

Keywords: Inflammatory bowel disease; Crohn’s disease; Interleukin-10; Recombinant human interleukin-10

Core tip: Inflammatory bowel disease (IBD) is a chronic condition with no known cure. This review addresses the current available treatments for IBD before discussing a potential new treatment strategy using the immunoregulatory cytokine interleukin-10 (IL-10). To date clinical trial results have been disappointing. We highlight the limitations of current IL-10 supplementation treatment and suggest how, with changes to IL-10 delivery and the correct choice of patient, IL-10 supplementation could become a viable treatment option.