Hisamatsu Tadakazu, Hayashida Mari
The Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Intest Res. 2017 Jul;15(3):318-327. doi: 10.5217/ir.2017.15.3.318. Epub 2017 Jun 12.
Behçet's disease (BD) is a chronic relapsing disease involving multiple organ systems. BD is characterized clinically by oral and genital aphthae, cutaneous lesions, and ophthalmological, neurological, and/or gastrointestinal manifestations. It is widely recognized that the presence of intestinal lesions may be a poor prognostic factor in intestinal BD, increasing the risk of surgery and decreasing the quality of life. Despite this, the management of intestinal BD has not been standardized. Empirical therapies including 5-aminosalicylic acid and corticosteroids have been used anecdotally to treat intestinal BD, but recent studies have provided evidence for the efficacy of anti-tumor necrosis factor α monoclonal antibodies. The development of agents targeting tumor necrosis factor α continues, it seems likely that they will change the therapeutic strategy and clinical outcomes of intestinal BD and inflammatory bowel disease. Monitoring disease activity such as endoscopic evaluation will become more important to obtain better outcomes. Here, we review current and future perspectives in the treatment and outcomes of intestinal BD.
白塞病(BD)是一种累及多个器官系统的慢性复发性疾病。BD的临床特征为口腔和生殖器溃疡、皮肤病变以及眼科、神经科和/或胃肠道表现。人们普遍认识到,肠道病变的存在可能是肠道BD预后不良的因素,会增加手术风险并降低生活质量。尽管如此,肠道BD的治疗尚未标准化。包括5-氨基水杨酸和皮质类固醇在内的经验性疗法曾被用于治疗肠道BD,但最近的研究为抗肿瘤坏死因子α单克隆抗体的疗效提供了证据。针对肿瘤坏死因子α的药物研发仍在继续,它们似乎有可能改变肠道BD和炎症性肠病的治疗策略及临床结局。监测疾病活动,如内镜评估,对于获得更好的治疗效果将变得更加重要。在此,我们综述肠道BD治疗及预后的当前和未来观点。