[克罗恩病中的肠道纤维化:面向新的治疗选择?]
Sophie Vieujean1,2, Émeline Bequet2,3, Marty Stepniak2
1Service de Gastro-entérologie, Hépatologie et Oncologie digestive, CHU Liège, Belgique.
Revue medicale de Liege
|March 13, 2025
概括
克罗恩病的狭窄性包括过度愈合和纤维化,缺乏特定的治疗方法. 新兴的疗法针对纤维化,为减少肠道并发症的侵入性手术提供希望.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 再生医学是一种再生医学.
背景情况:
- 克罗恩氏病 (CD) 是一种慢性炎症性肠病.
- 纤维肌性并发症,以纤维化引起的肠壁加厚为特征,在CD中很常见.
- 目前对CD狭窄的治疗侧重于炎症和阻塞,而不是直接扭转纤维化.
研究的目的:
- 审查克罗恩病中纤维肌性并发症的病理生理学.
- 讨论目前对CD肠道狭窄的管理策略.
- 突出新兴的治疗目标和策略,用于CD的抗纤维治疗.
主要方法:
- 病理生理学和目前治疗CD相关狭窄的文献综述.
- 针对纤维化途径的新型治疗剂的概述.
- 讨论正在进行的临床研究,包括介质干细胞疗法.
主要成果:
- 在CD中,肠道狭窄是由于失调的愈合和细胞外矩阵积累的结果.
- 抗瘤坏死因子 (TNF) 药物可以控制炎症,但不能逆转已建立的纤维化.
- 包括TL1A抑制剂,ALK5抑制剂和AGR2向治疗在内的几种新疗法正在研究中.
结论:
- 有效的抗纤维性疗法对于管理克罗恩病的肠收缩至关重要.
- 新的治疗方法旨在预防或逆转纤维化,可能减少对手术或扩张的需要.
- 诸如介质干细胞与内镜气球扩张相结合的研究方法显示出治疗的前景.
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