Division of Gastroenterology and Hepatology, Boston Medical Center, Boston, MA, USA.
Expert Rev Clin Immunol. 2023 Apr;19(4):431-438. doi: 10.1080/1744666X.2023.2185605. Epub 2023 Apr 12.
Inflammatory bowel disease (IBD) is a complex disease, caused by aberrant immune responses to environmental stimuli where genetic, metabolomic, and environmental variables interact to cause mucosal inflammation. This review sheds light on the different drug and patient related factors that affect personalization of biologics in IBD treatment.
We utilized the online research database PubMed to carry out literature search pertaining to therapies in IBD. We incorporated a combination of primary literature as well as review articles and meta-analyses in writing this clinical review. In this paper, we discuss the mechanisms of action for different biologics, the genotype and phenotype of patients, and pharmacokinetics/pharmacodynamics of drugs, as factors that influence response rates. We also touch upon the role of artificial intelligence in treatment personalization.
The future of IBD therapeutics is one of precision medicine, based on the identification of aberrant signaling pathways unique to individual patients as well as exploring the exposome, diet, viruses, and epithelial cell dysfunction as part of disease pathogenesis. We need global cooperation for pragmatic study designs as well as equitable access to machine learning/artificial intelligence technology to reach the unfulfilled potential of IBD care.
炎症性肠病（IBD）是一种复杂的疾病，由对环境刺激的异常免疫反应引起，其中遗传、代谢组学和环境变量相互作用导致黏膜炎症。这篇综述阐明了影响 IBD 治疗中生物制剂个体化的不同药物和患者相关因素。
我们利用在线研究数据库 PubMed 进行了与 IBD 治疗相关的文献检索。我们将主要文献以及综述文章和荟萃分析结合起来撰写了这篇临床综述。在本文中，我们讨论了不同生物制剂的作用机制、患者的基因型和表型以及药物的药代动力学/药效学，这些都是影响反应率的因素。我们还探讨了人工智能在治疗个体化中的作用。
IBD 治疗的未来是精准医学，基于识别个体患者特有的异常信号通路，以及探索外显子组、饮食、病毒和上皮细胞功能障碍在疾病发病机制中的作用。我们需要全球合作进行实用的研究设计，以及公平获得机器学习/人工智能技术，以充分发挥 IBD 护理的潜力。
