回肠和结肠克罗恩病：病变部位对治疗效果有影响吗？
Ileal and colonic Crohn's disease: Does location makes a difference in therapy efficacy?
作者信息
Atreya Raja, Bojarski Christian, Kühl Anja A, Trajanoski Zlatko, Neurath Markus F, Siegmund Britta
机构信息
Medical Clinic 1, Department of Medicine, University Hospital Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany.
Deutsches Zentrum Immuntherapie DZI, Erlangen, Germany.
出版信息
Curr Res Pharmacol Drug Discov. 2022 Mar 19;3:100097. doi: 10.1016/j.crphar.2022.100097. eCollection 2022.
Abstract
Within the IBD entity of Crohn's disease, there is currently no differentiation between ileal and colonic manifestation for recruitment of patients in clinical trials, well-powered analysis of study results or therapeutic decisions in daily clinical practice. However, there is accumulating evidence from epidemiological, genetic, microbial, immunological, and clinical characteristics that clearly indicate that ileal Crohn's disease represents a distinct disease entity, which differentiates itself from colonic Crohn's disease. This is also reflected by lower efficacy of targeted therapies in isolated ileal compared to colonic Crohn's disease. The distinct site-specific mechanisms that drive heightened non-response in ileal disease need to be analysed in-depth in the future, to enable optimized therapy in the individual Crohn's disease patient.
摘要
在克罗恩病的炎症性肠病范畴内，目前在临床试验中招募患者、对研究结果进行充分有力的分析或在日常临床实践中做出治疗决策时，并未区分回肠型和结肠型表现。然而，来自流行病学、遗传学、微生物学、免疫学和临床特征的证据不断积累，清楚地表明回肠型克罗恩病是一种独特的疾病实体，与结肠型克罗恩病有所不同。这也体现在与结肠型克罗恩病相比，靶向治疗在单纯回肠型疾病中的疗效较低。未来需要深入分析导致回肠型疾病中无反应性增加的独特部位特异性机制，以便为个体克罗恩病患者实现优化治疗。
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