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炎症性肠病的新兴药物治疗。

Emerging pharmacotherapy for inflammatory bowel diseases.

机构信息

Macau Centre for Research and Development in Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.

The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China.

出版信息

Pharmacol Res. 2022 Apr;178:106146. doi: 10.1016/j.phrs.2022.106146. Epub 2022 Feb 25.

DOI:10.1016/j.phrs.2022.106146
PMID:35227890
Abstract

Inflammatory bowel disease (IBD) refers to a gamut of disorders that are characterized by chronic intestinal inflammation, including ulcerative colitis (UC) and Crohn's disease (CD), which often leads to mucosal ulceration and progressive loss of intestinal function. The etiopathogenesis of IBD has not been completely clarified, although multiple factors involving genetic modifications, host immune dysfunction, intestinal dysbiosis and environmental effects have been implicated. Currently, pharmacotherapies including both non-targeted and targeted biological agents are widely used for the clinical treatment of IBD. In addition, novel therapeutic approaches that target the intestinal microorganisms, such as fecal microbiota transplantation, antibiotics, probiotics and microbial metabolite inhibitors, are also under development. However, these treatments are either accompanied by side effects or cannot achieve complete clinical remission when used alone. The efficacy and safety of drugs are currently a clinical challenge. Thus, advanced drug delivery systems are needed for targeted delivery of drugs to the inflammatory sites and avoid absorption by healthy tissues. In this review, we have summarized the latest research on the pathogenesis of IBD and the emerging pharmacotherapies, and discussed potential therapeutic targets for innovative therapies.

摘要

炎症性肠病(IBD)是一组以慢性肠道炎症为特征的疾病,包括溃疡性结肠炎(UC)和克罗恩病(CD),常导致黏膜溃疡和进行性肠道功能丧失。IBD 的发病机制尚未完全阐明,尽管涉及遗传改变、宿主免疫功能障碍、肠道菌群失调和环境影响等多种因素。目前,包括非靶向和靶向生物制剂在内的药物疗法广泛用于 IBD 的临床治疗。此外,针对肠道微生物的新型治疗方法,如粪便微生物移植、抗生素、益生菌和微生物代谢物抑制剂也在开发中。然而,这些治疗方法要么伴随着副作用,要么单独使用不能达到完全的临床缓解。药物的疗效和安全性目前是一个临床挑战。因此,需要先进的药物传递系统将药物靶向递送到炎症部位,并避免被健康组织吸收。在这篇综述中,我们总结了 IBD 的发病机制和新兴的药物治疗方法的最新研究,并讨论了创新治疗的潜在治疗靶点。

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