克罗恩病中的纤维狭窄性狭窄

Yoo Jun Hwan, Holubar Stefan, Rieder Florian

Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Department of Colorectal Surgery, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.

Intest Res. 2020 Oct;18(4):379-401. doi: 10.5217/ir.2019.09148. Epub 2020 Apr 10.

The use of biologic agents including anti-tumor necrosis factor monoclonal antibodies followed by anti-integrins and anti-interleukins has drastically changed the treatment paradigm of Crohn's disease (CD) by improving clinical symptoms and mucosal healing. However, up to 70% of CD patients still eventually undergo surgery mainly due to fibrostenotic strictures. There are no specific anti-fibrotic drugs yet. This review comprehensively addresses the mechanism, prediction, diagnosis and treatment of the fibrostenotic strictures in CD. We also introduce promising anti-fibrotic agents which may be available in the near future and summarize challenges in developing novel therapies to treat fibrostenotic strictures in CD.

包括抗肿瘤坏死因子单克隆抗体、抗整合素和抗白细胞介素在内的生物制剂的使用，通过改善临床症状和黏膜愈合，彻底改变了克罗恩病（CD）的治疗模式。然而，高达70%的CD患者最终仍需接受手术，主要原因是纤维狭窄性狭窄。目前尚无特异性抗纤维化药物。本综述全面探讨了CD中纤维狭窄性狭窄的机制、预测、诊断和治疗。我们还介绍了可能在不久的将来可用的有前景的抗纤维化药物，并总结了开发治疗CD纤维狭窄性狭窄新疗法面临的挑战。