Hazel Karl, O'Connor Anthony
Department of Gastroenterology, Tallaght University Hospital, Belgard Road, Tallaght, Dublin D24NR0A, Ireland.
Centre for Inflammatory Bowel Disease, Tallaght University Hospital, Dublin, Ireland University of Dublin, Trinity College, Dublin, Ireland.
Ther Adv Chronic Dis. 2020 Feb 5;11:2040622319899297. doi: 10.1177/2040622319899297. eCollection 2020.
Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is characterized by chronic inflammation, a relapsing and remitting clinical course, requirement for lifelong medication and often, significant morbidity. While multiple effective therapeutic options exist for the treatment of IBD, a proportion of patients will either fail to respond or lose response to therapy. Advances in therapeutics, such as the gut-specific anti-integrins, now offer patients an alternative option to systemic immunosuppression. Anti-interleukin 12 (anti-IL-12)/IL-23 agents offer new and effective treatment options for CD, while the oral small molecules now offer an oral alternative for the treatment of moderate-to-severe disease, previously requiring subcutaneous injection or intravenous infusion. Alternatives to pharmacological treatment such as stem-cell transplant and faecal microbiota transplant are also showing some promise in the treatment of both CD and UC.
炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),其特征为慢性炎症、临床病程呈复发缓解型、需要终身用药且往往伴有严重的发病率。虽然有多种有效的治疗方案可用于治疗IBD,但仍有一部分患者对治疗无反应或失去反应。治疗学的进展,如肠道特异性抗整合素,现在为患者提供了一种替代全身免疫抑制的选择。抗白细胞介素12(抗IL-12)/IL-23药物为CD提供了新的有效治疗选择,而口服小分子药物现在为中重度疾病的治疗提供了口服替代方案,此前这类疾病需要皮下注射或静脉输注。诸如干细胞移植和粪便微生物群移植等药物治疗的替代方法在治疗CD和UC方面也显示出一些前景。