Gerhard Rogler, Stephan Vavricka, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Zürich, 8091 Zürich, Switzerland.
World J Gastroenterol. 2013 Nov 21;19(43):7552-60. doi: 10.3748/wjg.v19.i43.7552.
The use of specific terms under different meanings and varying definitions has always been a source of confusion in science. When we point our efforts towards an evidence based medicine for inflammatory bowel diseases (IBD) the same is true: Terms such as "mucosal healing" or "deep remission" as endpoints in clinical trials or treatment goals in daily patient care may contribute to misconceptions if meanings change over time or definitions are altered. It appears to be useful to first have a look at the development of terms and their definitions, to assess their intrinsic and context-independent problems and then to analyze the different relevance in present-day clinical studies and trials. The purpose of such an attempt would be to gain clearer insights into the true impact of the clinical findings behind the terms. It may also lead to a better defined use of those terms for future studies. The terms "mucosal healing" and "deep remission" have been introduced in recent years as new therapeutic targets in the treatment of IBD patients. Several clinical trials, cohort studies or inception cohorts provided data that the long term disease course is better, when mucosal healing is achieved. However, it is still unclear whether continued or increased therapeutic measures will aid or improve mucosal healing for patients in clinical remission. Clinical trials are under way to answer this question. Attention should be paid to clearly address what levels of IBD activity are looked at. In the present review article authors aim to summarize the current evidence available on mucosal healing and deep remission and try to highlight their value and position in the everyday decision making for gastroenterologists.
在科学领域，不同含义和不同定义的特定术语的使用一直是造成混淆的一个根源。当我们致力于为炎症性肠病（IBD）制定循证医学时，同样如此：在临床试验中作为终点的“黏膜愈合”或“深度缓解”等术语，或者在日常患者护理中作为治疗目标，可能会因为其含义随时间而变化或定义发生改变而导致误解。首先了解一下这些术语的发展及其定义，评估其内在的和独立于上下文的问题，然后分析其在当今临床研究和试验中的不同相关性，似乎是有用的。这样做的目的是更清楚地了解这些术语背后的临床发现的真正影响。这也可能导致未来研究中对这些术语的使用更加明确。“黏膜愈合”和“深度缓解”这两个术语是近年来在 IBD 患者治疗中作为新的治疗目标而引入的。一些临床试验、队列研究或起始队列研究的数据表明，当达到黏膜愈合时，长期疾病进程更好。然而，目前仍不清楚在临床缓解的患者中，继续或增加治疗措施是否有助于或改善黏膜愈合。目前正在进行临床试验以回答这个问题。应该注意的是，要明确指出所研究的 IBD 活动水平。在这篇综述文章中，作者旨在总结目前关于黏膜愈合和深度缓解的现有证据，并尝试突出它们在日常决策中的价值和地位。
