Gastroenterology and Hepatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal.
Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal.
Aliment Pharmacol Ther. 2024 Nov;60(9):1166-1175. doi: 10.1111/apt.18263.
The possibility of preventing inflammatory bowel disease (IBD) is becoming more plausible due to advances in understanding preclinical disease and successful prevention trials in other immune-mediated diseases, such as type 1 diabetes and rheumatoid arthritis. However, before that possibility becomes reality, several efforts need to occur in parallel and in a coordinated way.
To propose some critical steps necessary for advancing the field of IBD prediction and prevention.
We reviewed the current literature to identify the necessary steps toward a preventive strategy for IBD.
The first step should determine the most robust predictive biomarkers and validate them across independent cohorts, creating a multidimensional predictive tool. The second step is to gain a better understanding of the preferences of first-degree relatives and people at risk for IBD, informing the implementation of screening and preventive strategies. Third, these efforts should contribute to the development of high-risk clinics and establish the necessary networks for disease prevention trials.
Advancing the field of IBD prediction and prevention will require a multifaceted approach, integrating biomarker discovery, understanding patient preferences, and establishing infrastructure for a collaborative network to support the practical implementation of IBD prevention strategies.
由于对临床前疾病的认识不断提高,以及在其他免疫介导性疾病(如 1 型糖尿病和类风湿关节炎)中成功进行了预防试验,预防炎症性肠病(IBD)的可能性变得越来越合理。然而,在这种可能性成为现实之前,需要平行且协调地进行几项努力。
提出推进 IBD 预测和预防领域所需的一些关键步骤。
我们回顾了当前的文献,以确定迈向 IBD 预防策略的必要步骤。
第一步应该确定最具稳健性的预测生物标志物,并在独立队列中对其进行验证,创建一个多维预测工具。第二步是更好地了解 IBD 一级亲属和高危人群的偏好,为筛查和预防策略的实施提供信息。第三,这些努力应该有助于高危诊所的发展,并为疾病预防试验建立必要的网络。
推进 IBD 预测和预防领域需要采取多方面的方法,整合生物标志物的发现、了解患者的偏好以及建立协作网络的基础设施,以支持 IBD 预防策略的实际实施。