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炎症性肠病中的内皮和心脏功能障碍:治疗是否改变了动脉和心脏结构及功能的炎症负荷?

Endothelial and Cardiac Dysfunction in Inflammatory Bowel Diseases: Does Treatment Modify the Inflammatory Load on Arterial and Cardiac Structure and Function?

机构信息

Department of Cardiology, Amalia Fleming General Hospital of Athens, Athens, Greece.

2nd Academic Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Curr Vasc Pharmacol. 2020;18(1):27-37. doi: 10.2174/1570161117666181129095941.

Abstract

Inflammatory bowel diseases (IBD), largely represented by Crohn's disease (CD) and ulcerative colitis (UC), alter gastrointestinal physiology and mucosal immunity through a complex inflammatory process. These diseases can lead to significant arterial endothelial dysfunction. There is also evidence linking IBD with a modification of cardiac structure and function. A growing body of research has associated IBD with an acceleration of arterial stiffness and atherosclerosis and an increased risk of cardiovascular (CV) morbidity and mortality. The focus of this review is two-fold. Firstly, the literature on IBD in relation to CV dysfunction was evaluated (mainly based on 25 relevant surveys carried out between 2005 and 2018). The vast majority of these studies support a significant association of IBD with a deterioration in CV function. Secondly, the literature available regarding the effect of IBD treatment on CV dysfunction was considered based on studies published between 2007 and 2018. This literature search suggests that IBD treatment may have the potential to ameliorate CV dysfunction resulting in CV benefits. This review will analyse the literature as well as consider emerging research perspectives regarding how IBD treatment could improve CV dysfunction.

摘要

炎症性肠病(IBD)主要包括克罗恩病(CD)和溃疡性结肠炎(UC),通过复杂的炎症过程改变胃肠道生理学和黏膜免疫。这些疾病可导致显著的动脉内皮功能障碍。也有证据表明 IBD 与心脏结构和功能的改变有关。越来越多的研究将 IBD 与动脉僵硬和动脉粥样硬化的加速以及心血管(CV)发病率和死亡率的增加联系起来。本综述的重点有两个方面。首先,评估了与 CV 功能障碍相关的 IBD 文献(主要基于 2005 年至 2018 年间进行的 25 项相关调查)。这些研究中的绝大多数都支持 IBD 与 CV 功能恶化有显著关联。其次,根据 2007 年至 2018 年期间发表的研究,考虑了关于 IBD 治疗对 CV 功能障碍影响的现有文献。这项文献检索表明,IBD 治疗可能有潜力改善 CV 功能障碍,从而带来 CV 益处。本综述将分析文献,并考虑关于 IBD 治疗如何改善 CV 功能障碍的新出现的研究观点。

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