潰瘍性大腸炎
Catherine Le Berre1, Sailish Honap2, Laurent Peyrin-Biroulet3
1Institut des Maladies de l'Appareil Digestif, Hépato-Gastro-Entérologie et Assistance Nutritionnelle, Inserm CIC 1413, Inserm UMR 1235, Nantes Université, CHU Nantes, Nantes, France.
Lancet (London, England)
|August 12, 2023
まとめ
潰瘍性大腸炎は 慢性的な腸炎で 世界中の何百万人もの人に 影響しています 新しい治療法では 寛解や内視鏡による治癒を 目指していますが 一部の患者は手術が必要で 精密医療の必要性を強調しています
科学分野:
- 胃腸内科
- 免疫学
- 内科 医学
背景:
- 潰瘍性大腸炎 (UC) は慢性炎症性腸疾患で,世界的に増加しています.
- UCの病原化には遺伝的傾向,環境的要因,腸内バリア機能障害,微生物群の変化,免疫機能不調が含まれます.
- 診断は臨床的,生物学的,内視鏡検査および組織学的評価に基づいています.
研究 の 目的:
- 潰瘍性大腸炎の現在の理解と管理を概説する.
- UCで寛解を誘発し維持するための治療戦略をレビューする.
- 精度とパーソナライズされた医療を重視したUC治療の将来の方向性を探求する.
主な方法:
- 潰瘍性大腸炎に関する最新医学文献のレビュー
- UCの診断基準と治療方法の分析
- 新しい治療目標とアプローチの議論
主要な成果:
- 現在の治療法は,UC管理のための5-アミノサリシル酸薬,コルチコステロイド,チオプリン,生物学的薬,および小分子を含む.
- 治療の進歩にもかかわらず,UC患者の10~20%は耐火性疾患のためにプロクトコレクトミーを必要とします.
- 治療選択肢の拡大は希望をもたらしますが 長期的な寛解と障害の予防には 課題が残っています
結論:
- 潰瘍性大腸炎の効果的な治療には,迅速な臨床的反応を誘発し,正常化されたバイオマーカーと内視鏡治療で長期的な寛解を維持する必要があります.
- 治療法,精密医療,パーソナライズされたアプローチの組み合わせは,潰瘍性大腸炎の現在の治療制限を克服することができます.
- UCの病原性と新しい治療戦略に関する研究が継続されることは,患者の治療結果を改善するために極めて重要です.
関連する概念動画
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
215
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
215
01:29Drugs for Treatment of Ulcerative Colitis in IBD
173
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
173
01:21Inflammatory Bowel Disease V: Surgical Management
170
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
170
01:17Chronic Bowel Disorders: Introduction
485
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
485
01:30Inflammatory Bowel Disease II: Crohn's Disease
291
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
291
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
355
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
355