Zhang Yi-Fang, Shi Ting Ting, Lin Yi-Ling, Zhu Yu-Ting, Lin Shu, Fang Tai-Yong
Department of Gastroenterology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, People's Republic of China.
Department of Gastroenterology, Anxi Maternal and Child Health Hospital, Quanzhou, Fujian, People's Republic of China.
J Inflamm Res. 2025 Aug 27;18:11821-11839. doi: 10.2147/JIR.S534447. eCollection 2025.
Inflammatory bowel disease (IBD), encompassing two subtypes, ulcerative colitis, and Crohn's disease, is a chronic, non-specific gastrointestinal disorder with a complex etiology stemming from various factors. The incidence of IBD has been steadily rising in the past few years, causing great physical and mental strain on patients. Traditional IBD therapeutic drugs include anti-inflammatory drugs, immunosuppressants, and biologics; however, they may have serious adverse effects. This has fueled active clinical research exploring new targets for IBD treatment, focusing on the unique metabolic pathways and functions of macrophages. Macrophage immune metabolism plays a crucial role in IBD; however, the mechanism is unclear. This review discussed the role and potential mechanisms of macrophage metabolic reprogramming in IBD and the link between macrophages and ferroptosis. While these findings from preclinical models suggest novel therapeutic avenues for IBD, such as targeting macrophage metabolic reprogramming and hypothetical approaches like ferroptosis modulation, their clinical applicability remains speculative; rigorous disease-specific validation is imperative.
炎症性肠病（IBD）包括两种亚型，即溃疡性结肠炎和克罗恩病，是一种慢性、非特异性胃肠道疾病，其病因复杂，源于多种因素。在过去几年中，IBD的发病率一直在稳步上升，给患者带来了巨大的身心压力。传统的IBD治疗药物包括抗炎药、免疫抑制剂和生物制剂；然而，它们可能有严重的不良反应。这推动了积极的临床研究，探索IBD治疗的新靶点，重点关注巨噬细胞独特的代谢途径和功能。巨噬细胞免疫代谢在IBD中起着关键作用；然而，其机制尚不清楚。本综述讨论了巨噬细胞代谢重编程在IBD中的作用和潜在机制，以及巨噬细胞与铁死亡之间的联系。虽然临床前模型的这些发现为IBD提出了新的治疗途径，如靶向巨噬细胞代谢重编程和铁死亡调节等假设方法，但其临床适用性仍具有推测性；必须进行严格的疾病特异性验证。
