Department of Gastroenterology and Hepatology, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Chronic Diseases and Metabolism, Translational Research Center for Gastrointestinal Disorders-Inflammatory Bowel Disease (TARGID-IBD), Katholieke Universiteit Leuven, Leuven, Belgium.
Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom.
Gastroenterology. 2022 Apr;162(5):1383-1395. doi: 10.1053/j.gastro.2021.12.245. Epub 2022 Jan 4.
Gastroenterologists will be all too familiar with the difficult decisions that managing inflammatory bowel disease often presents. How aggressively should I treat this patient? Do I expect them to have a mild or aggressive form of disease? Do they need a biologic? If so, which one? And when should I start it? The reality is that the answers that would be right for one patient might be disastrous for another. The growing therapeutic armamentarium will only make these decisions more difficult, and yet, we have seen how other specialties have begun to use the molecular heterogeneity in their diseases to provide some answers. Here, we review the progress that has been made in predicting the future for any given patient with inflammatory bowel disease-whether that is the course of disease that they will experience or whether or not they will respond to, or indeed tolerate, a particular therapy.
胃肠病学家对于在治疗炎症性肠病时经常面临的艰难抉择再熟悉不过了。我应该对这个患者采取多积极的治疗措施？我预计他们的疾病是轻度还是重度？他们需要使用生物制剂吗？如果需要，应该用哪种？以及何时开始使用？事实上，对一个患者来说正确的答案可能对另一个患者来说是灾难性的。日益增长的治疗手段只会让这些决策变得更加困难，但我们已经看到其他专业领域已经开始利用疾病中的分子异质性来提供一些答案。在这里，我们回顾了在预测炎症性肠病患者未来方面取得的进展——无论是他们将经历的疾病过程，还是他们对特定治疗的反应、耐受情况。
