Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.
J Dig Dis. 2021 Jul;22(7):390-398. doi: 10.1111/1751-2980.13022. Epub 2021 Jun 17.
Crohn's disease (CD) is a chronic and relapsing-remitting inflammatory disorder of the gastrointestinal tract. Approximately 70% of patients inevitably develop fibrosis-associated intestinal stricture after 10 years of CD diagnosis, which seriously affects their quality of life. Current therapies play limited role in preventing or reversing the process of fibrosis and no specific anti-fibrotic therapy is yet available. Nearly half of patients thus have no alternative but to receive surgery. The potential mechanisms of intestinal fibrosis remain poorly understood; extracellular matrix remodeling, aberrant immune response, intestinal microbiome imbalance and creeping fat might exert fundamental influences on the multiple physiological and pathophysiological processes. Recently, the emerging new diagnostic techniques have markedly promoted an accurate assessment of intestinal stricture by distinguishing fibrosis from inflammation, which is crucial for guiding treatment and predicting prognosis. In this review, we concisely summarized the key studies published in the year 2020 covering pathogenesis, diagnostic modalities, and therapeutic strategy of intestinal stricture. A comprehensive and timely review of the updated researches in intestinal stricture could provide insight to further elucidate its pathogenesis and identify novel drug targets with anti-fibrotic potentiality.
克罗恩病（CD）是一种慢性、复发缓解性的胃肠道炎症性疾病。约 70%的患者在 CD 诊断后 10 年内不可避免地会发展为纤维化相关的肠道狭窄，严重影响其生活质量。目前的治疗方法在预防或逆转纤维化过程中的作用有限，尚无特异性的抗纤维化治疗方法。因此，近一半的患者别无选择，只能接受手术。肠道纤维化的潜在机制仍知之甚少；细胞外基质重塑、异常免疫反应、肠道微生物组失衡和潜行脂肪可能对多种生理和病理生理过程产生根本影响。最近，新兴的新技术显著促进了通过区分纤维化和炎症来准确评估肠道狭窄，这对于指导治疗和预测预后至关重要。在这篇综述中，我们简要总结了 2020 年发表的涵盖肠道狭窄发病机制、诊断方法和治疗策略的关键研究。对肠道狭窄更新研究的全面及时回顾可以深入了解其发病机制，并确定具有抗纤维化潜力的新型药物靶点。
