Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Gastroenterology, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, United Kingdom.
St Mark's Academic Institute, London North West University Hospitals National Health Service Trust, London, United Kingdom; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom.
Gastroenterology. 2022 Apr;162(5):1525-1542. doi: 10.1053/j.gastro.2021.09.077. Epub 2022 Jan 4.
Inflammatory bowel disease is characterized by significant interindividual heterogeneity. With a wider selection of pharmacologic and nonpharmacologic interventions available and in advanced developmental stages, a priority for the coming decade is to determine accurate methods of predicting treatment response and disease course. Precision medicine strategies will allow tailoring of preventative and therapeutic decisions to individual patient needs. In this review, we consider the future of precision medicine in inflammatory bowel disease. We discuss the critical need to extend from research focused on short-term symptomatic response to integrative multi-omic systems biology strategies to identify and validate biomarkers that underpin precision approaches. Crucially, the international community has collective responsibility to provide well-phenotyped and -curated longitudinal datasets for scientific discovery and validation. Research must also study broader aspects of the immune response, including components of the extracellular matrix, to better understand biological pathways initiating and perpetuating tissue fibrosis and longer-term disease complications.
炎症性肠病的特点是个体间存在显著异质性。随着可供选择的药物和非药物治疗方法越来越多，且处于高级发展阶段，未来十年的当务之急是确定准确的方法来预测治疗反应和疾病进程。精准医学策略将使预防和治疗决策能够针对个体患者的需求进行调整。在这篇综述中，我们探讨了炎症性肠病精准医学的未来。我们讨论了从关注短期症状反应的研究扩展到整合多组学系统生物学策略的迫切需要，以确定和验证支持精准方法的生物标志物。至关重要的是，国际社会有共同的责任为科学发现和验证提供表型良好且经过精心整理的纵向数据集。研究还必须研究免疫反应的更广泛方面，包括细胞外基质的组成部分，以更好地了解启动和持续组织纤维化和长期疾病并发症的生物学途径。
