Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
Physiol Rev. 2022 Apr 1;102(2):605-652. doi: 10.1152/physrev.00005.2021. Epub 2021 Sep 27.
Intestinal fibrosis is considered an inevitable complication of Crohn's disease (CD) that results in symptoms of obstruction and stricture formation. Endoscopic or surgical treatment is required to treat the majority of patients. Progress in the management of stricturing CD is hampered by the lack of effective antifibrotic therapy; however, this situation is likely to change because of recent advances in other fibrotic diseases of the lung, liver, and skin. In this review, we summarize data from randomized controlled trials (RCTs) of antifibrotic therapies in these conditions. Multiple compounds have been tested for antifibrotic effects in other organs. According to their mechanisms, they were categorized into growth factor modulators, inflammation modulators, 5-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, intracellular enzymes and kinases, renin-angiotensin system (RAS) modulators, and others. From our review of the results from the clinical trials and discussion of their implications in the gastrointestinal tract, we have identified several molecular candidates that could serve as potential therapies for intestinal fibrosis in CD.
肠纤维化被认为是克罗恩病（CD）不可避免的并发症，导致梗阻和狭窄形成的症状。大多数患者需要进行内镜或手术治疗。由于缺乏有效的抗纤维化治疗，限制 CD 的管理进展受到阻碍；然而，由于肺部、肝脏和皮肤等其他纤维化疾病的最新进展，这种情况可能会改变。在这篇综述中，我们总结了这些疾病中抗纤维化治疗的随机对照试验（RCT）的数据。多种化合物已在其他器官中进行了抗纤维化作用的测试。根据其机制，它们被分为生长因子调节剂、炎症调节剂、5-羟-3-甲基戊二酰基辅酶 A（HMG-CoA）还原酶抑制剂、细胞内酶和激酶、肾素-血管紧张素系统（RAS）调节剂和其他。通过对临床试验结果的回顾和对其在胃肠道中意义的讨论，我们确定了几个分子候选物，它们可能成为 CD 肠纤维化的潜在治疗方法。
