通过神经刺激的神经免疫调节可降低克罗恩病患者的炎症活动:一项前性的开放标签研究
Geert D'Haens1, Michael Eberhardson2,3, Zeljko Cabrijan4,5,6
1Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands.
Journal of Crohn's & colitis
|September 22, 2023
概括
神经刺激为克罗恩病提供了一种安全有效的新疗法,可显著降低炎症并改善治疗耐药性疾病患者的生活质量.
科学领域:
- 神经免疫学 神经免疫学
- 胃肠病学 胃肠病学
- 医疗器械 医疗器械
背景情况:
- 克罗恩氏病 (CD) 是一种慢性胃肠道炎症疾病,治疗选择有限.
- 目前的治疗方法在不到一半的患者中实现了持续缓解.
- 迷走神经的"炎症反射"显示出免疫调节潜力,此前在类风湿性关节炎和生物原始性CD.中观察到.
研究的目的:
- 为了研究迷走神经刺激 (VNS) 的安全性和有效性,在治疗不耐药的CD患者中.
- 探索VNS作为一种新的治疗方法来管理中度至重度的CD.
- 评估CD中VNS的临床,内镜,分子和患者报告的结果.
主要方法:
- 一个开放的,多中心的临床试验,涉及17名生物耐药性CD患者.
- 阴道神经刺激器植入,随后进行16周的诱导治疗和24个月的维持治疗.
- 评估临床改善,患者报告的结果,内镜和分子炎症标志物和安全性.
主要成果:
- 在CD活动指数 (CDAI) 和便calprotectin水平的统计学显著降低.
- 在大多数用对内镜检查的患者中,观察到粘膜炎症的减少.
- 降低了促炎性细胞因子 (TNF和IFN-γ) 的血清水平,并改善了一些患者的生活质量.
结论:
- 迷走神经刺激 (VNS) 在治疗耐药克罗恩病患者中证明了安全性和耐受性.
- VNS导致疾病活动,内镜炎症和关键炎症标志物的临床上有意义的减少.
- 通过VNS进行神经免疫调节为克罗恩病管理提供了一个有前途的治疗策略.
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