Iacucci Marietta, Ghosh Subrata
Division of Gastroenterology, Snyder Institute of Chronic Inflammation, University of Calgary, Calgary, Alta., Canada.
Dig Dis. 2016;34(1-2):160-4. doi: 10.1159/000443133. Epub 2016 Mar 16.
Mucosal healing has emerged as an important outcome measure of treatment in inflammatory bowel disease (IBD). It is increasingly incorporated in the outcome measures of clinical trials along with patient reported outcomes and used in clinical practice as a therapeutic target or goal. The exact definition of mucosal healing continues to evolve and several scoring systems have been developed, some of which require further validation. Considerable inter-observer variation may also exist in interpretation of mucosal appearance in IBD. Novel endoscopic techniques demonstrate that even in patients who have achieved mucosal healing by conventional criteria, subtle inflammation may continue to persist. Whether mucosal healing needs to incorporate or reflect histological healing is a topic of intense debate and further studies. In addition, surrogate markers of mucosal healing, such as fecal calprotectin, may serve as a therapeutic target, but there is debate about whether normalization of fecal calprotectin always reflects mucosal healing. Patients with mucosal healing may also continue to have clinical symptoms reflecting visceral hypersensitivity.
黏膜愈合已成为炎症性肠病（IBD）治疗的一项重要疗效指标。它越来越多地被纳入临床试验的疗效指标中，与患者报告的结果一起使用，并在临床实践中作为治疗靶点或目标。黏膜愈合的确切定义仍在不断演变，已经开发了几种评分系统，其中一些还需要进一步验证。在IBD中，观察者之间对黏膜外观的解读也可能存在相当大的差异。新型内镜技术表明，即使是那些通过传统标准已实现黏膜愈合的患者，细微的炎症可能仍会持续存在。黏膜愈合是否需要纳入或反映组织学愈合是一个激烈争论且有待进一步研究的话题。此外，黏膜愈合的替代标志物，如粪便钙卫蛋白，可作为治疗靶点，但对于粪便钙卫蛋白正常化是否总能反映黏膜愈合存在争议。黏膜愈合的患者也可能会持续出现反映内脏高敏感性的临床症状。
