在IBD中如何评估纤维化?
Helena Tavares de Sousa1,2, Fernando Magro3,4,5
1Gastroenterology Department, Algarve University Hospital Center, 8500-338 Portimão, Portugal.
Diagnostics (Basel, Switzerland)
|July 14, 2023
概括
纤维化显著影响炎症性肠病 (IBD),影响克罗恩病 (CD) 和性结肠炎 (UC) 不同. 虽然非侵入性方法有希望,但外科病理学仍然是诊断肠道纤维化的黄金标准.
科学领域:
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
- 医疗成像医学成像
背景情况:
- 纤维化是炎症性肠病 (IBD) 的关键并发症,在克罗恩病 (CD) 和性结肠炎 (UC) 中具有明显的表现.
- 了解炎症和纤维化之间的相互作用,包括炎症独立的纤维生成,对于疾病管理至关重要.
- 对肠道纤维化的准确评估对于IBD有效的治疗策略至关重要.
研究的目的:
- 审查纤维化在IBD中的重要性,区分其对CD和UC的影响.
- 探索炎症和纤维化之间的相关性,以及炎症独立纤维生成的机制.
- 讨论肠道纤维化非侵入性评估的最新进展,包括成像和生物标志物.
主要方法:
- 审查有关IBD纤维化,炎症纤维化相关性和纤维化现有文献.
- 分析当前的非侵入性评估技术:截面成像 (CSI),磁共振弹性成像 (MRE),弹性成像,放射学和生物标志物 (微型RNA).
- 对手术病理学的各种非侵入性方法的诊断准确度和局限性的比较.
主要成果:
- 目前没有一种CSI技术可以准确测量CD纤维化;MRE和弹性图显示出潜力.
- 放射学表明纤维化评估的初步结果令人鼓舞,需要进一步验证可靠的生物标志物.
- 微RNA研究是有前途的,但对于纤维化生物标志物开发,需要有验证的终点的强有力的临床试验.
结论:
- 在IBD中对肠道纤维化的非侵入性评估正在发展,放射学和人工智能 (AI) 准备在CSI中发挥未来的作用.
- 尽管有进展,外科病理学仍然是诊断和量化IBD肠道纤维化的最终方法.
- 需要进一步的研究和验证的临床试验,以建立可靠的非侵入性生物标志物和IBD纤维化成像技术.
相关概念视频
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
357
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...
357
Inflammatory Bowel Disease II: Crohn's Disease
298
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...
298
Inflammatory Bowel Disease I: Ulcerative Colitis
222
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...
222
Chronic Bowel Disorders: Introduction
489
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...
489
Ultrasound II: Endoscopic Ultrasound and FibroScan
143
Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
Endoscopic Ultrasound (EUS):
143
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
175
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
175


