Kaser Arthur, Tilg Herbert
Innsbruck Medical University, Department of Gastroenterology and Hepatology, Christian Doppler Research Laboratory for Gut Inflammation, Innsbruck, Austria.
Expert Opin Ther Targets. 2009 Feb;13(2):259-63. doi: 10.1517/14728220802682325.
More than 12,000 gastroenterologists attended the United European Gastroenterology Week 2008 meeting in Vienna. As in recent years, presentations on inflammatory bowel diseases (IBDs) were among the hot topics. One of the plenary lectures presented the first results of the landmark Study of Biologic and Immunomodulator Naive Patients in Crohn's Disease, a large collaborative worldwide study assessing the effects of azathioprine or infliximab monotherapy versus the combination of both drugs in early Crohn's patients. Interestingly, monotherapy with infliximab was significantly more effective than azathioprine after a 30-week treatment period; however, highest remission rates were observed in combination therapy with infliximab plus azathioprine. This study might affect the treatment of Crohn's patients in the future. Several studies addressed basic immunological aspects in IBDs. It has recently been established that the epithelial cell is crucial in the pathogenesis of these barrier diseases as genetic defects, for example, in the X-box binding protein-1 (XBP1), lead to spontaneous enteritis. Besides these cells, intestinal fibroblasts and microvascular endothelial cells are increasingly recognized as contributing to various extents to the disease process. Inflammatory bowel disease remains at the forefront of research in gastroenterology and recent findings will result in new treatment strategies.
超过12000名胃肠病学家参加了2008年在维也纳举行的欧洲胃肠病学联合周会议。与近年来一样,关于炎症性肠病(IBDs)的报告是热门话题之一。一场全会演讲展示了针对初治克罗恩病患者的生物制剂和免疫调节剂的里程碑式研究的首批结果,这是一项全球范围内的大型合作研究,评估硫唑嘌呤或英夫利昔单抗单药治疗与两种药物联合治疗对早期克罗恩病患者的效果。有趣的是,在30周的治疗期后,英夫利昔单抗单药治疗比硫唑嘌呤显著更有效;然而,英夫利昔单抗加硫唑嘌呤的联合治疗观察到最高的缓解率。这项研究可能会影响未来克罗恩病患者的治疗。几项研究探讨了IBDs的基础免疫学方面。最近已经确定,上皮细胞在这些屏障疾病的发病机制中至关重要,因为例如X盒结合蛋白-1(XBP1)的基因缺陷会导致自发性肠炎。除了这些细胞,肠道成纤维细胞和微血管内皮细胞在疾病过程中的不同程度作用也越来越受到认可。炎症性肠病仍然是胃肠病学研究的前沿领域,最近的研究结果将带来新的治疗策略。