Vuitton Lucine, Peyrin-Biroulet Laurent
Rev Prat. 2014 Nov;64(9):1232-6.
Crohn's disease and ulcerative colitis are chronic, progressive, destructive and disabling conditions. So far therapeutic strategies based only on the relief of symptoms did not change the natural history of inflammatory bowel diseases (BD). In Crohn's disease the concept of deep remission, which includes clinical and inflammatory (endoscopic and biologic) remission, is emerging. In ulcerative colitis, evidence accumulates to recommend achieving and maintaining mucosal healing as assessed by proctosigmoidoscopy. Whether histologic remission is the ultimate therapeutic goal in ulcerative colitis will require further investigation. These new therapeutic targets may be the best way to change disease course (hospitalizations, surgery) and to prevent disability in IBD.
克罗恩病和溃疡性结肠炎是慢性、进行性、破坏性和致残性疾病。到目前为止,仅基于症状缓解的治疗策略并未改变炎症性肠病(IBD)的自然病程。在克罗恩病中,包括临床缓解和炎症(内镜及生物学)缓解的深度缓解概念正在兴起。在溃疡性结肠炎中,越来越多的证据表明应通过直肠乙状结肠镜检查评估实现并维持黏膜愈合。组织学缓解是否为溃疡性结肠炎的最终治疗目标仍需进一步研究。这些新的治疗靶点可能是改变疾病进程(住院、手术)以及预防IBD致残的最佳途径。