双重生物疗法和小分子在儿科炎症性肠病中的小分子
Francesca Penagini1, Luisa Lonoce1, Luisa Abbattista1
1Department of Pediatrics, "Vittore Buzzi" Children's Hospital, Milano, Italy.
Pharmacological research
|September 25, 2023
概括
对于儿科炎性肠病 (IBD) 新的治疗策略正在出现. 本综述总结了关于儿童IBD小分子药物和组合疗法的最新数据.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 炎症性肠道疾病 (IBD),包括克罗恩病 (CD) 和性结肠炎 (UC),是慢性胃肠道疾病.
- 抗瘤坏死因子抗体 (anti-TNFα) 是重症儿科IBD的第一线生物药物,其他生物药物用于非标签.
- 显著比例的儿科IBD患者 (高达30%) 不对生物药物有反应或随着时间的推移失去反应,需要新的治疗选择.
研究的目的:
- 审查有关儿科IBD新兴治疗策略的当前文献.
- 总结有关儿童IBD新疗法的安全性和疗效的现有数据.
- 为儿童IBD管理提供新药开发和治疗方法的概述.
主要方法:
- 关于儿科IBD治疗的最新研究的文献综述.
- 对小分子药物 (SMD) 和组合疗法的数据分析.
- 关于在儿科IBD中非标签使用生物药物的信息综合.
主要成果:
- 关于SMD和儿科IBD组合疗法等新型治疗方案的安全性和疗效的数据有限.
- 目前的研究重点是开发新的药物和策略,以解决儿科IBD中生物治疗失败的问题.
- 非标签使用的二线生物药物,如 vedolizumab (VDZ) 和 ustekinumab (UST) 在儿科IBD中很常见.
结论:
- 对儿童IBD新疗法的安全性和疗效进行更多研究是非常必要的.
- 小分子药物和组合疗法代表了治疗耐药儿科IBD的有希望的途径.
- 优化治疗策略对于改善IBD儿童的治疗结果至关重要,这些儿童未能对现有疗法做出反应.
相关概念视频
Inflammatory Bowel Disease IV: Pharmacological Management
145
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
145
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
164
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...
164
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
186
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
186
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
144
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
144
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
348
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...
348
Drugs for Treatment of Ulcerative Colitis in IBD
164
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...
164


