Gibson Peter R
Monash University Department of Medicine, Box Hill Hospital, Box Hill, Victoria, Australia.
J Gastroenterol Hepatol. 2009 Oct;24 Suppl 3:S63-8. doi: 10.1111/j.1440-1746.2009.06073.x.
Inflammatory diseases of the intestine, including Crohn's disease, ulcerative colitis, and celiac disease are now very common in Australia and remain major challenges for clinicians. Australian (and New Zealand) clinicians and scientists have made considerable contributions to our current understanding of these diseases over the last 50 years, including pathogenesis (such as the 'butyrate hypothesis', 'endoplasmic reticulum (ER) stress', and the identification of the peptide sequences that incite celiac disease), true population epidemiology (albeit in New Zealand), precise clinical observation, new investigative tools, innovative new potential therapies, influential clinical drug trials (such as triple antibiotics for Crohn's disease), and a dietary approach with efficacy for functional gut symptoms (the low FODMAP diet). Underpinning the success has been clinical excellence and adaptation of clinicians to the changing landscape of disease severity and therapeutic options. The future is indeed bright if such trends continue.
肠道炎症性疾病,包括克罗恩病、溃疡性结肠炎和乳糜泻,目前在澳大利亚非常普遍,仍然是临床医生面临的重大挑战。在过去50年里,澳大利亚(和新西兰)的临床医生和科学家为我们目前对这些疾病的理解做出了相当大的贡献,包括发病机制(如“丁酸盐假说”“内质网应激”以及引发乳糜泻的肽序列的鉴定)、真实的人群流行病学(尽管是在新西兰)、精确的临床观察、新的研究工具、创新的潜在新疗法、有影响力的临床药物试验(如用于克罗恩病的三联抗生素)以及对功能性肠道症状有效的饮食方法(低聚果糖饮食)。取得成功的基础是卓越的临床水平以及临床医生对疾病严重程度和治疗选择不断变化的适应能力。如果这种趋势持续下去,未来确实充满希望。