Research Department, Sidra Medicine, Doha 26999, Qatar.
Division of Gastroenterology, Hepatology and Nutrition, Sidra Medicine, Doha 26999, Qatar.
Int J Mol Sci. 2022 Jun 23;23(13):6966. doi: 10.3390/ijms23136966.
Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammation of the gastrointestinal tract with a highly heterogeneous presentation. It has a relapsing and remitting clinical course that necessitates lifelong monitoring and treatment. Although the availability of a variety of effective therapeutic options including immunomodulators and biologics (such as TNF, CAM inhibitors) has led to a paradigm shift in the treatment outcomes and clinical management of IBD patients, some patients still either fail to respond or lose their responsiveness to therapy over time. Therefore, according to the recent Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) recommendations, continuous disease monitoring from symptomatic relief to endoscopic healing along with short- and long-term therapeutic responses are critical for providing IBD patients with a tailored therapy algorithm. Moreover, considering the high unmet need for novel therapeutic approaches for IBD patients, various new modulators of cytokine signaling events (for example, JAK/TYK inhibitors), inhibitors of cytokines (for example IL-12/IL-23, IL-22, IL-36, and IL-6 inhibitors), anti-adhesion and migration strategies (for example, β7 integrin, sphingosine 1-phosphate receptors, and stem cells), as well as microbial-based therapeutics to decolonize the bed buds (for example, fecal microbiota transplantation and bacterial inhibitors) are currently being evaluated in different phases of controlled clinical trials. This review aims to offer a comprehensive overview of available treatment options and emerging therapeutic approaches for IBD patients. Furthermore, predictive biomarkers for monitoring the therapeutic response to different IBD therapies are also discussed.
炎症性肠病(IBD)是一种慢性免疫介导的胃肠道炎症,表现高度异质。它具有反复发作和缓解的临床病程,需要终身监测和治疗。尽管有多种有效的治疗选择,包括免疫调节剂和生物制剂(如 TNF、CAM 抑制剂),这导致了 IBD 患者治疗结果和临床管理的范式转变,但有些患者仍然无法对治疗产生反应或随着时间的推移失去对治疗的反应。因此,根据最近的炎症性肠病选择治疗靶点(STRIDE-II)建议,从症状缓解到内镜愈合的持续疾病监测以及短期和长期治疗反应对于为 IBD 患者提供量身定制的治疗方案至关重要。此外,考虑到 IBD 患者对新型治疗方法的高度未满足需求,目前正在不同的对照临床试验阶段评估各种细胞因子信号事件的新型调节剂(例如 JAK/TYK 抑制剂)、细胞因子抑制剂(例如 IL-12/IL-23、IL-22、IL-36 和 IL-6 抑制剂)、抗粘附和迁移策略(例如β7 整联蛋白、鞘氨醇 1-磷酸受体和干细胞)以及用于定植芽的微生物治疗(例如粪便微生物移植和细菌抑制剂)。本综述旨在全面概述 IBD 患者的现有治疗选择和新兴治疗方法。此外,还讨论了用于监测不同 IBD 治疗方法治疗反应的预测生物标志物。
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