Department of Inflammation & Immunity, Lerner Research Institute, and Department of Gastroenterology, Hepatology & Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence,Italy.
J Crohns Colitis. 2021 Sep 25;15(9):1410-1430. doi: 10.1093/ecco-jcc/jjab051.
Many diseases that affect modern humans fall in the category of complex diseases, thus called because they result from a combination of multiple aetiological and pathogenic factors. Regardless of the organ or system affected, complex diseases present major challenges in diagnosis, classification, and management. Current forms of therapy are usually applied in an indiscriminate fashion based on clinical information, but even the most advanced drugs only benefit a limited number of patients and to a variable and unpredictable degree. This 'one measure does not fit all' situation has spurred the notion that therapy for complex disease should be tailored to individual patients or groups of patients, giving rise to the notion of 'precision medicine' [PM]. Inflammatory bowel disease [IBD] is a prototypical complex disease where the need for PM has become increasingly clear. This prompted the European Crohn's and Colitis Organisation to focus the Seventh Scientific Workshop on this emerging theme. The articles in this special issue of the Journal address the various complementary aspects of PM in IBD, including what PM is; why it is needed and how it can be used; how PM can contribute to prediction and prevention of IBD; how IBD PM can aid in prognosis and improve response to therapy; and the challenges and future directions of PM in IBD. This first article of this series is structured on three simple concepts [what, why, and how] and addresses the definition of PM, discusses the rationale for the need of PM in IBD, and outlines the methodology required to implement PM in IBD in a correct and clinically meaningful way.
许多影响现代人的疾病都属于复杂疾病,因此被称为复杂疾病,因为它们是由多种病因和发病因素共同作用的结果。无论受影响的器官或系统如何,复杂疾病在诊断、分类和管理方面都带来了重大挑战。目前的治疗形式通常是根据临床信息不加区分地应用,但即使是最先进的药物也只能使有限数量的患者受益,而且受益程度是可变的和不可预测的。这种“一刀切”的情况促使人们认为,复杂疾病的治疗应该针对个体患者或患者群体进行定制,从而产生了“精准医学”[PM]的概念。炎症性肠病[IBD]是一种典型的复杂疾病,对 PM 的需求变得越来越明显。这促使欧洲克罗恩病和结肠炎组织将第七次科学研讨会的重点放在这一新兴主题上。本期杂志特刊中的文章涉及 IBD 中 PM 的各个互补方面,包括 PM 是什么;为什么需要 PM 以及如何使用 PM;PM 如何有助于预测和预防 IBD;IBD PM 如何有助于预后并改善对治疗的反应;以及 PM 在 IBD 中的挑战和未来方向。本系列的第一篇文章基于三个简单的概念[是什么、为什么和如何],介绍了 PM 的定义,讨论了在 IBD 中需要 PM 的基本原理,并概述了以正确和有临床意义的方式在 IBD 中实施 PM 所需的方法。