Medical Clinic 1, Friedrich-Alexander University Clinic, University of Erlangen-Nürnberg, Erlangen, Germany.
Mucosal Immunol. 2014 Jan;7(1):6-19. doi: 10.1038/mi.2013.73. Epub 2013 Oct 2.
Healing of the inflamed mucosa (mucosal healing) is an emerging new goal for therapy and predicts clinical remission and resection-free survival in inflammatory bowel diseases (IBDs). The era of antitumor necrosis factor (TNF) antibody therapy was a remarkable progress in IBD therapy and anti-TNF agents led to mucosal healing in a subgroup of IBD patients; however, many patients do not respond to anti-TNF treatment highlighting the relevance of finding new targets for therapy of IBD. In particular, current studies are addressing the role of other anticytokine agents including antibodies against interleukin (IL)-6R, IL-13, and IL-12/IL-23 as well as new anti-inflammatory concepts (regulatory T cell therapy, Smad7 antisense, Jak inhibition, Toll-like receptor 9 stimulation, worm eggs). In addition, blockade of T-cell homing via the integrins α4β7 and the addressin mucosal vascular addressin cell adhesion molecule 1 (MAdCAM-1) emerges as a promising new approach for IBD therapy. Here, new approaches for achieving mucosal healing are discussed as well as their implications for future therapy of IBD.
炎症黏膜的愈合（黏膜愈合）是治疗的新兴新目标，可预测炎症性肠病（IBD）的临床缓解和无切除生存。抗肿瘤坏死因子（TNF）抗体治疗的时代是 IBD 治疗的显著进展，抗 TNF 药物使 IBD 患者亚组的黏膜愈合；然而，许多患者对抗 TNF 治疗无反应，突出了寻找 IBD 治疗新靶点的相关性。特别是，目前的研究正在探讨其他抗细胞因子药物的作用，包括针对白细胞介素（IL）-6R、IL-13 和 IL-12/IL-23 的抗体以及新的抗炎概念（调节性 T 细胞治疗、Smad7 反义寡核苷酸、Jak 抑制、Toll 样受体 9 刺激、蠕虫卵）。此外，通过整合素 α4β7 和黏膜血管地址素细胞黏附分子 1（MAdCAM-1）阻断 T 细胞归巢，为 IBD 治疗提供了一种很有前途的新方法。在此，讨论了实现黏膜愈合的新方法及其对 IBD 未来治疗的影响。
