Department of Gastroenterology and Hepatology, University Hospital of Linköping, 581 91 Linköping, Sweden.
Department of Medicine, Center for Bioelectronic Medicine, Bioclinicum, Karolinska Institutet, 171 64 Stockholm, Sweden.
Int Immunol. 2021 Jun 7;33(6):349-356. doi: 10.1093/intimm/dxab018.
The hallmark of inflammatory bowel diseases (IBD) is chronic intestinal inflammation with typical onset in adolescents and young adults. An abundance of neutrophils is seen in the inflammatory lesions, but adaptive immunity is also an important player in the chronicity of the disease. There is an unmet need for new treatment options since modern medicines such as biological therapy with anti-cytokine antibodies still leave a substantial number of patients with persisting disease activity. The role of the central nervous system and its interaction with the gut in the pathophysiology of IBD have been brought to attention both in animal models and in humans after the discovery of the inflammatory reflex. The suggested control of gut immunity by the brain-gut axis represents a novel therapeutic target suitable for bioelectronic intervention. In this review, we discuss the role of the inflammatory reflex in gut inflammation and the recent advances in the treatment of IBD by intervening with the brain-gut axis through bioelectronic devices.
炎症性肠病(IBD)的标志是慢性肠道炎症,典型发病年龄为青少年和年轻成年人。在炎症病变中可见大量中性粒细胞,但适应性免疫也是疾病慢性化的重要参与者。由于现代药物(如抗细胞因子抗体的生物疗法)仍有大量患者存在持续的疾病活动,因此需要新的治疗选择。在发现炎症反射后,中枢神经系统及其与肠道的相互作用在 IBD 的病理生理学中的作用在动物模型和人类中都得到了关注。大脑-肠道轴对肠道免疫的控制作用代表了一个新的治疗靶点,适合生物电子干预。在这篇综述中,我们讨论了炎症反射在肠道炎症中的作用,以及通过生物电子设备干预大脑-肠道轴治疗 IBD 的最新进展。