Nordic Bioscience A/S, Herlev, Denmark.
Takeda Development Centers of America, Boston, USA.
Expert Rev Gastroenterol Hepatol. 2023 Jan-Jun;17(6):575-587. doi: 10.1080/17474124.2023.2212158. Epub 2023 May 24.
Crohn's disease (CD) is a complex disease, and assessing activity is challenging due to pathobiologic process e.g. ECM remodeling, mucosal damage, and intestinal fibrosis, which greatly limits current disease activity assessments through e.g. endoscopy and imaging techniques.
The review highlights the importance of novel biomarkers reflecting ECM remodeling and immune cell activity that accurately reflect CD activity and progression. Such biomarkers could include collagen formation and degradation fragments and a serum fragment of calprotectin, reflecting neutrophil activity. A new concept, fibro-inflammation, is also introduced in the review, in which all aspects of mucosal damage, such as inflammation, mucosal damage, tissue remodeling, intestinal fibrosis, and fibrosis resolution, should be assessed. PubMed searches performed from July 2022 - November 2022 provided the scientific information included in the review.
Current data suggest intestinal fibrosis may sustain and exacerbate chronic inflammation, leading to non-response to anti-inflammatory treatments. Therefore, evaluating novel biomarkers reflecting different stages of fibro-inflammatory disease activity should be done in a clinical setting and considered for clinical trials. This approach will help accurately assess disease activity, leading to better management and treatment of CD.
克罗恩病（CD）是一种复杂的疾病，由于其病理生理过程，如细胞外基质重塑、黏膜损伤和肠道纤维化，评估其活动度具有挑战性，这极大地限制了目前通过内镜和影像学技术等进行的疾病活动评估。
本综述强调了反映细胞外基质重塑和免疫细胞活性的新型生物标志物的重要性，这些标志物可以准确反映 CD 的活动度和进展。此类生物标志物可能包括胶原形成和降解片段以及反映中性粒细胞活性的血清钙卫蛋白片段。在本综述中还引入了一个新概念，即纤维炎症，其中应评估黏膜损伤的所有方面，如炎症、黏膜损伤、组织重塑、肠道纤维化和纤维化消退。从 2022 年 7 月至 2022 年 11 月，在 PubMed 上进行了检索，提供了本综述中包含的科学信息。
目前的数据表明，肠道纤维化可能会维持和加剧慢性炎症，导致对抗炎治疗无反应。因此，应在临床环境中评估反映不同阶段纤维炎症疾病活动的新型生物标志物，并考虑将其用于临床试验。这种方法将有助于准确评估疾病活动度，从而更好地管理和治疗 CD。
