Second Department of Surgery, Aretaieion Hospital, Medical School, University of Athens, Athens, Greece.
J Gastrointest Surg. 2014 Jun;18(6):1216-24. doi: 10.1007/s11605-014-2487-3. Epub 2014 Mar 6.
Tumor necrosis factor (TNF)α is a cytokine exerting pleiotropic effects on critical cell functions and, most importantly, is the main regulator of pro-inflammatory cytokine production and a key player in the pathophysiology of numerous autoimmune diseases, including Crohn's disease.
TNFα became a therapeutic target and TNFα blocking agents are currently used in the treatment of inflammatory diseases. Beyond the therapeutic benefits deriving from TNFα neutralization, amendments in the cellular functions of the immune system may as well induce potent immunosuppressive effects. An attenuated immune response may compromise the intestinal healing ability, thus leading to weaker anastomosis and increased risk of anastomotic leak and septic complications.
This hypothesis raises great concerns about the safety of perioperative administration of anti-TNF and has been the endpoint of numerous studies.
The aim of this review is to critically evaluate the evidence regarding the role of TNFα in anastomosis related complications after abdominal surgery in Crohn's disease patients.
肿瘤坏死因子 (TNF)α 是一种细胞因子，对关键细胞功能具有多种作用，最重要的是，它是促炎细胞因子产生的主要调节剂，也是许多自身免疫性疾病（包括克罗恩病）病理生理学的关键参与者。
TNFα 成为治疗靶点，TNFα 阻断剂目前用于治疗炎症性疾病。除了 TNFα 中和带来的治疗益处外，免疫系统细胞功能的改变也可能引发强烈的免疫抑制作用。减弱的免疫反应可能会损害肠道愈合能力，从而导致吻合口更弱，吻合口漏和感染性并发症的风险增加。
这一假设对围手术期使用抗 TNF 的安全性提出了极大的担忧，这也是众多研究的终点。
本综述的目的是批判性地评估 TNFα 在克罗恩病患者腹部手术后吻合口相关并发症中的作用的证据。
