IL23R and Cowden disease: CD involves activation of Th1 or Th17 cells and the contribution of IL-12/23 as a pro-inflammatory cytokine to the condition.10,11 A genome-wide association study identified a significant association between CD and the IL-23 receptor.12 UST is a fully humanized immunoglobulin G1 kappa (IgG1κ) monoclonal antibody (mAb), which binds with high affinity to the p40 subunit common to both IL-12 and IL-23 and is approved for use in moderate-to-severe CD patients who were non-responders to previous treatment.