Centre for Cancer and Inflammation Research, Hong Kong Baptist University, 7 Baptist University Road, Kowloon Tong, Hong Kong SAR, China.
Curr Pharm Des. 2014;20(7):1082-96. doi: 10.2174/13816128113199990416.
Ulcerative colitis (UC) and Crohn's disease (CD) constitute the two major groups of idiopathic disorders in inflammatory bowel disease (IBD). Environmental factors, genetic factors and immune responses have been considered as the major etiology of IBD. Despite the diversified pathogenesis of the disease, no guaranteed curative therapeutic regimen has been developed so far. This review summarizes the knowledge on the pathophysiology and current treatment approaches of IBD. Since IBD is caused by excessive and tissue- disruptive inflammatory reactions of the gut wall, down-regulation of the immune responses may allow the damaged mucosa to heal and reset the physiological functions of the gut back to normal. Current pharmacotherapy through modulation of neutrophil-derived factors, cytokines, adhesion molecules and reactive oxygen/nitrogen metabolites has been utterly described. Categories of treatment modalities include corticosteroids, aminosalicylates, immunomodulators, antibiotics, probiotics, and a series of unique novel agents. The use of anti-tumor necrosis factor monoclonal antibody (Infliximab), recombinant anti-inflammatory cytokines and related gene therapy has been covered. In addition, discussions on dietary supplementation and heparin treatment are also included. The anti-inflammatory and immunoregulatory potential of investigational agents such as nicotine and the filtered protective compounds from tobacco smoke, as well as active herbal medicinal compounds were tested in our previous experimental works, whereas promising findings have been presented here. With the discovery of novel target-oriented agents, more effective and relatively harmless approaches of IBD therapy could be established to achieve a curative outcome. Indeed, more experimental and clinical studies are needed to confirm the relevance of these therapies.
溃疡性结肠炎（UC）和克罗恩病（CD）构成了炎症性肠病（IBD）中两种主要的特发性疾病。环境因素、遗传因素和免疫反应被认为是 IBD 的主要病因。尽管该病的发病机制多样化，但迄今为止尚未开发出有保证的治愈性治疗方案。本文综述了 IBD 的病理生理学和当前治疗方法的知识。由于 IBD 是由肠道壁过度和组织破坏性炎症反应引起的，因此下调免疫反应可能允许受损的黏膜愈合，并使肠道的生理功能恢复正常。目前通过调节中性粒细胞衍生因子、细胞因子、黏附分子和活性氧/氮代谢物的药物治疗已被彻底描述。治疗方式包括皮质类固醇、氨基水杨酸盐、免疫调节剂、抗生素、益生菌和一系列独特的新型药物。抗肿瘤坏死因子单克隆抗体（英夫利昔单抗）、重组抗炎细胞因子和相关基因治疗的应用也包括在内。此外，还包括对饮食补充和肝素治疗的讨论。在我们以前的实验工作中，已经测试了研究药物如尼古丁和烟草烟雾中过滤的保护化合物以及活性草药化合物的抗炎和免疫调节潜力，并且在这里提出了有希望的发现。随着新型靶向药物的发现，可以建立更有效和相对无害的 IBD 治疗方法，以实现治愈效果。实际上，需要更多的实验和临床研究来证实这些治疗方法的相关性。
