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肠道白塞病的更新治疗策略。

Updated treatment strategies for intestinal Behçet's disease.

作者信息

Park Yong Eun, Cheon Jae Hee

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Korean J Intern Med. 2018 Jan;33(1):1-19. doi: 10.3904/kjim.2017.377. Epub 2017 Dec 8.

Abstract

Behçet's disease (BD) is a chronic, idiopathic, relapsing immune-mediated disease involving multiple organs, and is characterized by recurrent oral and genital ulcers, ocular disease, gastrointestinal ulcers, vascular diseases, and skin lesions. In particular, gastrointestinal involvement in BD is followed by severe complications, including massive bleeding, bowel perforation, and fistula, which can lead to significant morbidity and mortality. However, the management of intestinal BD has not yet been properly established. Intestinal BD patients with a severe clinical course experience frequent disease aggravations and often require recurrent corticosteroid and/or immunomodulatory therapies, or even surgery. However, a considerable number of patients with intestinal BD are often refractory to conventional therapies such as corticosteroids and immunomodulators. Recently, there has been a line of evidence suggesting that biologics such as infliximab and adalimumab are effective in treating intestinal BD. Moreover, new biologics targeting proteins other than tumor necrosis factor α are emerging and are under active investigation. Therefore, in this paper, we review the current therapeutic strategies and new clinical data for the treatment of intestinal BD.

摘要

白塞病(BD)是一种慢性、特发性、复发性免疫介导性疾病,累及多个器官,其特征为复发性口腔和生殖器溃疡、眼部疾病、胃肠道溃疡、血管疾病及皮肤病变。特别是,BD累及胃肠道后会引发严重并发症,包括大量出血、肠穿孔和瘘管,可导致显著的发病率和死亡率。然而,肠道BD的治疗方法尚未得到妥善确立。临床病程严重的肠道BD患者疾病频繁加重,常需反复使用皮质类固醇和/或免疫调节疗法,甚至手术治疗。然而,相当一部分肠道BD患者往往对皮质类固醇和免疫调节剂等传统疗法耐药。最近,有一系列证据表明,英夫利昔单抗和阿达木单抗等生物制剂在治疗肠道BD方面有效。此外,针对肿瘤坏死因子α以外蛋白质的新型生物制剂不断涌现,正在积极研究中。因此,在本文中,我们综述了肠道BD治疗的当前策略和新的临床数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e782/5768550/1634fb250f73/kjim-2017-377f1.jpg

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