细胞因子在炎症性肠病发病机制中的作用。

Role of cytokines in the pathogenesis of inflammatory bowel disease.

作者信息

Papadakis K A, Targan S R

机构信息

Division of Gastroenterology, Cedars-Sinai Medical Center, University of California, Los Angeles 90048, USA.

出版信息

Annu Rev Med. 2000;51:289-98. doi: 10.1146/annurev.med.51.1.289.

DOI:10.1146/annurev.med.51.1.289

PMID:10774465

Abstract

Recent advances in the drug treatment of inflammatory bowel disease (IBD) have paralleled our understanding of the pathophysiology of ulcerative colitis and Crohn's disease. Several proinflammatory and immune-regulatory cytokines are upregulated in the mucosa of patients with IBD, and differences and similarities in the cytokine profiles of ulcerative colitis and Crohn's disease have been elucidated. Several clinical trials involving a chimeric anti-TNF-alpha (tumor necrosis factor-alpha) antibody have shown marked clinical benefit in the majority of patients with Crohn's disease, verifying the importance of TNF-alpha in the pathogenesis of Crohn's disease. In preliminary studies, treatment with recombinant human interleukin-10 has been beneficial in Crohn's disease but not in ulcerative colitis. Future treatment of IBD may include combination or sequential cytokine and anticytokine administration in defined groups of patients based on their mucosal cytokine profiles.

摘要

炎症性肠病（IBD）药物治疗的最新进展与我们对溃疡性结肠炎和克罗恩病病理生理学的理解同步。几种促炎和免疫调节细胞因子在IBD患者的黏膜中上调，并且已经阐明了溃疡性结肠炎和克罗恩病细胞因子谱的异同。几项涉及嵌合抗TNF-α（肿瘤坏死因子-α）抗体的临床试验显示，大多数克罗恩病患者有显著的临床获益，证实了TNF-α在克罗恩病发病机制中的重要性。在初步研究中，重组人白细胞介素-10治疗对克罗恩病有益，但对溃疡性结肠炎无效。IBD的未来治疗可能包括根据患者的黏膜细胞因子谱，在特定患者群体中联合或序贯给予细胞因子和抗细胞因子药物。