Camilleri Michael
Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R) Program, Mayo Clinic College of Medicine, Charlton 8-110, 200 First Street SW, Rochester, MN 55905, U.S.A.
Br J Pharmacol. 2004 Apr;141(8):1237-48. doi: 10.1038/sj.bjp.0705741. Epub 2004 Mar 22.
This article summarizes the ongoing challenges in irritable bowel syndrome and the exciting opportunities for development of novel therapies for this common, enigmatic condition. The challenges include insufficient understanding of mechanisms, lack of specificity of symptoms, differentiation from other conditions, and lack of availability of noninvasive tests to identify dysfunctions. However, significant opportunities are reflected by the advances in clinical trial design and, particularly, clinically relevant end points for such trials, and the increasing understanding of basic neuroenteric science. The latter has delivered two new medications to the practice (alosetron and tegaserod), and other candidate therapies (other serotonergic, tachykininergic, opioid, cannabinoid modulators) are being carefully appraised as potential drugs for the future.
本文总结了肠易激综合征当前面临的挑战以及针对这一常见疑难病症开发新疗法的令人振奋的机遇。这些挑战包括对发病机制的理解不足、症状缺乏特异性、与其他病症的鉴别困难以及缺乏用于识别功能障碍的无创检测方法。然而，临床试验设计的进展，尤其是此类试验具有临床相关性的终点指标，以及对基础神经胃肠科学认识的不断加深，都反映出了重大的机遇。后者已为临床实践带来了两种新药（阿洛司琼和替加色罗），其他候选疗法（其他5-羟色胺能、速激肽能、阿片样物质、大麻素调节剂）也正在作为未来潜在药物进行仔细评估。
