China 
Africa 
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Medical Treatment of IBD
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Naveen Sharma, Michael R.B. Keighley, Severine Vermeire
Alicaforsen is an intercellular adhesion molecule (ICAM)-1 antisense oligonucleotide designed for rectal (local) administration in UC patients.18 ICAM is a transmembrane protein that is expressed on many cell types involved in intestinal inflammation such as epithelial, endothelial and immune cells. It is involved in leucocyte migration as well as cell-to-cell immune signalling; blocking this molecule should therefore act on intestinal inflammation at multiple levels. This might explain why clinical studies in UC patients show both long and short (although not confirmed by every trial) term efficacy.
Host-directed therapies for malaria and tuberculosis: common infection strategies and repurposed drugs
Published in Expert Review of Anti-infective Therapy, 2022
Piyush Baindara, Sonali Agrawal, O. L. Franco
Over-expression of ICAM-1 occurs in a wide variety of inflammatory disorders including malaria and tuberculosis [16,26,170]. Alicaforsen, an anti-sense oligonucleotide ICAM-1, selectively inhibits ICAM-1 by down-regulating ICAM-1 mRNA. Alicaforsen binds to the ICAM-1 mRNA, leading to the formation of a DNA: RNA heteroduplex which leaves the ICAM-1 mRNA ineffective and vulnerable to cleavage by ribonucleases, thus reducing ICAM-1 expression and preventing the inflammatory response [171]. Efalizumab, a humanized immunoglobulin mAb directed against LFA-1, was approved in 2003 for the treatment of psoriasis. LFA-1 binds the ICAM and plays a role in APC and T-cell adhesion, antibody production, T-cell trafficking, and co-stimulation. By blocking LFA-1, efalizumab inhibits T-cell proliferation and cytokine synthesis [172]. As both alicaforsen and efalizumab inhibit the expression of ICAM-1, thus their efficacy may also be tested for treating deadly infections like malaria, tuberculosis, and co-infections.
Inflammatory bowel disease: new therapies from antisense oligonucleotides
Published in Annals of Medicine, 2018
Irene Marafini, Giovanni Monteleone
In an open-label, uncontrolled study alicaforsen enema was administered nightly to 12 patients with chronic unremitting pouchitis for 6 weeks [47]. The drug was well tolerated and effective in reducing clinical and endoscopic signs of inflammation. Altogether, these results led FDA to consider alicaforsen as an orphan drug, which can be prescribed as an unlicensed medicine in accordance with international regulation in patients with pouchitis and patients with left-sided UC.