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胃肠道表现:食管表现为重点,发病机制的最新研究进展。

GI Manifestations With a Focus on the Esophagus: Recent Progress in Understanding Pathogenesis.

机构信息

Department of Medicine, Gastroenterology and Hepatology Division, Northwestern University Feinberg School of Medicine, 15-753 Tarry Building, 300 East Superior Street, Chicago, IL, 60611-3010, USA.

出版信息

Curr Rheumatol Rep. 2019 Jul 3;21(8):42. doi: 10.1007/s11926-019-0841-x.

Abstract

PURPOSE OF REVIEW

Esophageal dysfunction is common in systemic sclerosis (SSc) patients. Limited treatment options are available for scleroderma esophageal disease. Here, we discuss recent updates on the diagnosis, treatment, and characterization that have been made in patients with scleroderma esophageal disease.

RECENT FINDINGS

In the past few years, novel diagnostic tools have provided insight into esophageal dysmotility in SSc patients. New drugs are being tested and might improve symptoms and quality of life in SSc patients with esophageal dysfunction. Molecular stratification methods have facilitated the identification of molecular signatures in the esophagus of SSc patients. The Friend leukemia integration 1 (Fli1) conditional knockout mouse is the first animal model to report an esophageal phenotype with SSc features. The clinical presentation in SSc patients with esophageal dysfunction is heterogeneous, complicating diagnosis and management. The improvement of diagnostic tools for esophageal symptoms and dysfunction and the use of molecular approaches in SSc mouse models and patient biopsies offer an opportunity to improve the characterization of SSc esophageal disease, which should help improve management and treatment decisions.

摘要

目的综述

食管功能障碍在系统性硬化症(SSc)患者中较为常见。目前针对硬皮病性食管病的治疗方法有限。本文讨论了硬皮病性食管病患者在诊断、治疗和特征方面的最新进展。

最近发现

在过去几年中,新型诊断工具深入了解了 SSc 患者的食管动力障碍。正在测试新药物,有望改善食管功能障碍的 SSc 患者的症状和生活质量。分子分层方法促进了 SSc 患者食管中分子特征的鉴定。Friend 白血病整合 1(Fli1)条件性敲除小鼠是第一个报告具有 SSc 特征的食管表型的动物模型。食管功能障碍的 SSc 患者的临床表现存在异质性,使诊断和管理变得复杂。食管症状和功能障碍诊断工具的改进,以及 SSc 小鼠模型和患者活检中分子方法的应用,为改善 SSc 食管病的特征提供了机会,这应该有助于改善管理和治疗决策。

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