Targan Stephan R, Karp Loren C
Cedars-Sinai Inflammatory Bowel Disease Center, Los Angeles, California 90048, USA.
Curr Opin Gastroenterol. 2007 Jul;23(4):390-4. doi: 10.1097/MOG.0b013e3281722271.
Progress in inflammatory bowel disease, aided by use of animal models, and focused on pathways leading to inflammation and the relationship between the innate and adaptive immune systems, is identifying target pathogenic mechanisms for therapeutic intervention. This review will describe the most recent advances and discuss promising pathways for therapeutic discovery.
Identification and testing of immune and genetic markers to distinguish subgroups of patients with inflammatory bowel disease have surged over the last decade. What was limited to a few serum antibodies is now complemented with a number of genetic associations. Recent years have seen renewed interest, with additional evidence on the relationship between intestinal commensal bacteria and the inflammatory process in Inflammatory bowel disease.
There is emerging evidence that discriminating pathogenic abnormalities are present in certain clusters of patients, defined by selected immune responses. These traits have been used to identify correlates between relevant mouse models and immunophenotypic clusters of patients. Such approaches will not only help us to more easily define groups of patients for study, but will also enhance our understanding of the interface between various pathways and disease expression, and ultimately, identify the primal therapeutic targets in the appropriate subgroups of patients.
借助动物模型,炎症性肠病研究取得进展,重点关注导致炎症的途径以及固有免疫系统与适应性免疫系统之间的关系,从而确定治疗干预的目标致病机制。本综述将描述最新进展,并讨论治疗发现的有潜力的途径。
在过去十年中,用于区分炎症性肠病患者亚组的免疫和遗传标志物的鉴定与测试激增。过去仅限于少数血清抗体,现在有了许多基因关联作为补充。近年来,人们重新产生兴趣,有更多证据表明肠道共生细菌与炎症性肠病炎症过程之间的关系。
有新证据表明,在某些由特定免疫反应定义的患者群体中存在致病性异常。这些特征已被用于确定相关小鼠模型与患者免疫表型群体之间的相关性。此类方法不仅将帮助我们更轻松地定义用于研究的患者群体,还将增进我们对各种途径与疾病表现之间界面的理解,并最终在合适的患者亚组中确定主要治疗靶点。