Di Rienzo Annalisa, Marinelli Lisa, Dimmito Marilisa Pia, Toto Eleonora Chiara, Di Stefano Antonio, Cacciatore Ivana
Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.
Pharmaceutics. 2024 Sep 7;16(9):1185. doi: 10.3390/pharmaceutics16091185.
Inflammatory bowel disease (IBD) is a chronic gastrointestinal inflammatory disorder with two main subtypes: ulcerative colitis (UC) and Crohn's disease (CD). The pathogenesis involves genetic predisposition, dysbiosis, and immune dysregulation. Complications include perianal lesions, strictures, fistulas, perforations, and an increased risk of colon cancer. Clinical classification ranges from mild to fulminant and recurrent disease, with common symptoms such as abdominal discomfort, rectal bleeding, diarrhea, and weight loss. Extraintestinal manifestations include arthritis, erythema nodosum, pyoderma gangrenosum, and uveitis. Conventional treatments using aminosalicylates, corticosteroids, and immunomodulators have limitations. Biologics, introduced in the 1990s, offer improved efficacy and specificity, targeting factors like TNF-α, integrins, and cytokines. Monoclonal antibodies play a crucial role in IBD management, aiming to reduce relapses, hospitalizations, and surgeries. In conclusion, this review is aimed at summarizing the latest knowledge, advantages, and drawbacks of IBD therapies, such as small molecules, biologics, and monoclonal antibodies, to provide a basis for further research in the IBD field.
炎症性肠病（IBD）是一种慢性胃肠道炎症性疾病，主要有两种亚型：溃疡性结肠炎（UC）和克罗恩病（CD）。其发病机制涉及遗传易感性、微生物群失调和免疫调节异常。并发症包括肛周病变、狭窄、瘘管、穿孔以及结肠癌风险增加。临床分类从轻度到暴发性和复发性疾病不等，常见症状有腹部不适、直肠出血、腹泻和体重减轻。肠外表现包括关节炎、结节性红斑、坏疽性脓皮病和葡萄膜炎。使用氨基水杨酸类药物、皮质类固醇和免疫调节剂的传统治疗方法存在局限性。20世纪90年代引入的生物制剂具有更高的疗效和特异性，可靶向肿瘤坏死因子-α、整合素和细胞因子等因子。单克隆抗体在IBD治疗中起着关键作用，旨在减少复发、住院和手术。总之，本综述旨在总结IBD治疗方法（如小分子药物、生物制剂和单克隆抗体）的最新知识、优点和缺点，为IBD领域的进一步研究提供依据。
